|
HC SENSITIVITY DISK DIFFUSION
|
Facility
|
IP
|
$367.00
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
900912403
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$73.40 |
| Max. Negotiated Rate |
$330.30 |
| Rate for Payer: Adventist Health Commercial |
$73.40
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Central Health Plan Commercial |
$293.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$256.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.80
|
| Rate for Payer: EPIC Health Plan Senior |
$146.80
|
| Rate for Payer: Galaxy Health WC |
$311.95
|
| Rate for Payer: Global Benefits Group Commercial |
$220.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$330.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$233.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$216.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.40
|
| Rate for Payer: Multiplan Commercial |
$275.25
|
| Rate for Payer: Networks By Design Commercial |
$238.55
|
| Rate for Payer: Prime Health Services Commercial |
$311.95
|
|
|
HC SENSITIVITY DISK DIFFUSION
|
Facility
|
OP
|
$367.00
|
|
|
Service Code
|
CPT 87184
|
| Hospital Charge Code |
900912403
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$6.06 |
| Max. Negotiated Rate |
$330.30 |
| Rate for Payer: Adventist Health Commercial |
$73.40
|
| Rate for Payer: Adventist Health Commercial |
$9.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.48
|
| Rate for Payer: Adventist Health Medi-Cal |
$7.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$50.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$69.66
|
| Rate for Payer: Blue Shield of California Commercial |
$28.98
|
| Rate for Payer: Blue Shield of California Commercial |
$231.21
|
| Rate for Payer: Blue Shield of California EPN |
$18.26
|
| Rate for Payer: Blue Shield of California EPN |
$145.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$20.70
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Cash Price |
$165.15
|
| Rate for Payer: Central Health Plan Commercial |
$293.60
|
| Rate for Payer: Central Health Plan Commercial |
$36.80
|
| Rate for Payer: Cigna of CA HMO |
$29.44
|
| Rate for Payer: Cigna of CA HMO |
$234.88
|
| Rate for Payer: Cigna of CA PPO |
$34.04
|
| Rate for Payer: Cigna of CA PPO |
$271.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$256.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.34
|
| Rate for Payer: EPIC Health Plan Senior |
$8.23
|
| Rate for Payer: EPIC Health Plan Senior |
$8.23
|
| Rate for Payer: Galaxy Health WC |
$39.10
|
| Rate for Payer: Galaxy Health WC |
$311.95
|
| Rate for Payer: Global Benefits Group Commercial |
$27.60
|
| Rate for Payer: Global Benefits Group Commercial |
$220.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$41.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$330.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.27
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$233.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$29.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.02
|
| Rate for Payer: Multiplan Commercial |
$34.50
|
| Rate for Payer: Multiplan Commercial |
$275.25
|
| Rate for Payer: Networks By Design Commercial |
$238.55
|
| Rate for Payer: Networks By Design Commercial |
$29.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.48
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7.48
|
| Rate for Payer: Prime Health Services Commercial |
$39.10
|
| Rate for Payer: Prime Health Services Commercial |
$311.95
|
| Rate for Payer: Prime Health Services Medicare |
$7.93
|
| Rate for Payer: Prime Health Services Medicare |
$7.93
|
| Rate for Payer: Riverside University Health System MISP |
$8.23
|
| Rate for Payer: Riverside University Health System MISP |
$8.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$220.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$220.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.06
|
| Rate for Payer: United Healthcare All Other HMO |
$6.06
|
| Rate for Payer: United Healthcare All Other HMO |
$6.06
|
| Rate for Payer: United Healthcare HMO Rider |
$6.06
|
| Rate for Payer: United Healthcare HMO Rider |
$6.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.06
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.48
|
| Rate for Payer: Upland Medical Group Pediatric |
$7.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.23
|
| Rate for Payer: Vantage Medical Group Senior |
$7.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7.48
|
|
|
HC SENSITIVITY E TESTS
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912404
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.00 |
| Max. Negotiated Rate |
$22.81 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.81
|
| Rate for Payer: Blue Shield of California Commercial |
$132.30
|
| Rate for Payer: Blue Shield of California Commercial |
$12.60
|
| Rate for Payer: Blue Shield of California EPN |
$83.37
|
| Rate for Payer: Blue Shield of California EPN |
$7.94
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Central Health Plan Commercial |
$16.00
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Cigna of CA HMO |
$134.40
|
| Rate for Payer: Cigna of CA HMO |
$12.80
|
| Rate for Payer: Cigna of CA PPO |
$155.40
|
| Rate for Payer: Cigna of CA PPO |
$14.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.84
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Galaxy Health WC |
$17.00
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Global Benefits Group Commercial |
$12.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Multiplan Commercial |
$15.00
|
| Rate for Payer: Networks By Design Commercial |
$13.00
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.75
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.75
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
| Rate for Payer: Prime Health Services Commercial |
$17.00
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Riverside University Health System MISP |
$5.22
|
| Rate for Payer: Riverside University Health System MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$126.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC SENSITIVITY E TESTS
|
Facility
|
IP
|
$210.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912404
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$42.00 |
| Max. Negotiated Rate |
$189.00 |
| Rate for Payer: Adventist Health Commercial |
$42.00
|
| Rate for Payer: Cash Price |
$94.50
|
| Rate for Payer: Central Health Plan Commercial |
$168.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$147.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$84.00
|
| Rate for Payer: EPIC Health Plan Senior |
$84.00
|
| Rate for Payer: Galaxy Health WC |
$178.50
|
| Rate for Payer: Global Benefits Group Commercial |
$126.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$189.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$133.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$123.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.00
|
| Rate for Payer: Multiplan Commercial |
$157.50
|
| Rate for Payer: Networks By Design Commercial |
$136.50
|
| Rate for Payer: Prime Health Services Commercial |
$178.50
|
|
|
HC SENSITIVITY GRAM NEGATIVE MIC
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912414
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.43
|
| Rate for Payer: Blue Shield of California Commercial |
$197.19
|
| Rate for Payer: Blue Shield of California Commercial |
$55.44
|
| Rate for Payer: Blue Shield of California EPN |
$34.94
|
| Rate for Payer: Blue Shield of California EPN |
$124.26
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Cigna of CA HMO |
$200.32
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$231.62
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$61.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Senior |
$9.52
|
| Rate for Payer: EPIC Health Plan Senior |
$9.52
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.59
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
|
|
HC SENSITIVITY GRAM NEGATIVE MIC
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912414
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC SENSITIVITY GRAM POSITIVE MIC
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912412
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC SENSITIVITY GRAM POSITIVE MIC
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912412
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.43
|
| Rate for Payer: Blue Shield of California Commercial |
$197.19
|
| Rate for Payer: Blue Shield of California Commercial |
$55.44
|
| Rate for Payer: Blue Shield of California EPN |
$34.94
|
| Rate for Payer: Blue Shield of California EPN |
$124.26
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Cigna of CA HMO |
$200.32
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$231.62
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$61.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Senior |
$9.52
|
| Rate for Payer: EPIC Health Plan Senior |
$9.52
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.59
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
|
|
HC SENSITIVITY MIC
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900911558
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC SENSITIVITY MIC
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900911558
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.43
|
| Rate for Payer: Blue Shield of California Commercial |
$197.19
|
| Rate for Payer: Blue Shield of California Commercial |
$55.44
|
| Rate for Payer: Blue Shield of California EPN |
$34.94
|
| Rate for Payer: Blue Shield of California EPN |
$124.26
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Cigna of CA HMO |
$200.32
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$231.62
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$61.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Senior |
$9.52
|
| Rate for Payer: EPIC Health Plan Senior |
$9.52
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.59
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
|
|
HC SENSITIVITY STREP MIC
|
Facility
|
IP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912413
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$62.60 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.20
|
| Rate for Payer: EPIC Health Plan Senior |
$125.20
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$184.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
|
|
HC SENSITIVITY STREP MIC
|
Facility
|
OP
|
$313.00
|
|
|
Service Code
|
CPT 87186
|
| Hospital Charge Code |
900912413
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$281.70 |
| Rate for Payer: Adventist Health Commercial |
$62.60
|
| Rate for Payer: Adventist Health Commercial |
$17.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Adventist Health Medi-Cal |
$8.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$63.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$87.43
|
| Rate for Payer: Blue Shield of California Commercial |
$197.19
|
| Rate for Payer: Blue Shield of California Commercial |
$55.44
|
| Rate for Payer: Blue Shield of California EPN |
$34.94
|
| Rate for Payer: Blue Shield of California EPN |
$124.26
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$140.85
|
| Rate for Payer: Cash Price |
$39.60
|
| Rate for Payer: Central Health Plan Commercial |
$70.40
|
| Rate for Payer: Central Health Plan Commercial |
$250.40
|
| Rate for Payer: Cigna of CA HMO |
$200.32
|
| Rate for Payer: Cigna of CA HMO |
$56.32
|
| Rate for Payer: Cigna of CA PPO |
$231.62
|
| Rate for Payer: Cigna of CA PPO |
$65.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$61.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$219.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.27
|
| Rate for Payer: EPIC Health Plan Senior |
$9.52
|
| Rate for Payer: EPIC Health Plan Senior |
$9.52
|
| Rate for Payer: Galaxy Health WC |
$74.80
|
| Rate for Payer: Galaxy Health WC |
$266.05
|
| Rate for Payer: Global Benefits Group Commercial |
$52.80
|
| Rate for Payer: Global Benefits Group Commercial |
$187.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$79.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$281.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$14.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$198.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$55.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.59
|
| Rate for Payer: Multiplan Commercial |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$234.75
|
| Rate for Payer: Networks By Design Commercial |
$203.45
|
| Rate for Payer: Networks By Design Commercial |
$57.20
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8.65
|
| Rate for Payer: Prime Health Services Commercial |
$266.05
|
| Rate for Payer: Prime Health Services Commercial |
$74.80
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Prime Health Services Medicare |
$9.17
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Riverside University Health System MISP |
$9.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$187.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare All Other HMO |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare HMO Rider |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Upland Medical Group Pediatric |
$8.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.52
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
| Rate for Payer: Vantage Medical Group Senior |
$8.65
|
|
|
HC SENSORY INTEGRAT TECH 15 MIN MCAL
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
900400062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$43.00 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Adventist Health Commercial |
$43.00
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Central Health Plan Commercial |
$172.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.00
|
| Rate for Payer: EPIC Health Plan Senior |
$86.00
|
| Rate for Payer: Galaxy Health WC |
$182.75
|
| Rate for Payer: Global Benefits Group Commercial |
$129.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$161.25
|
| Rate for Payer: Networks By Design Commercial |
$139.75
|
| Rate for Payer: Prime Health Services Commercial |
$182.75
|
|
|
HC SENSORY INTEGRAT TECH 15 MIN MCAL
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
900400062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$88.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$122.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$182.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$118.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$161.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Central Health Plan Commercial |
$172.00
|
| Rate for Payer: Cigna of CA HMO |
$137.60
|
| Rate for Payer: Cigna of CA PPO |
$159.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$182.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$182.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.00
|
| Rate for Payer: EPIC Health Plan Senior |
$86.00
|
| Rate for Payer: Galaxy Health WC |
$182.75
|
| Rate for Payer: Global Benefits Group Commercial |
$129.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$150.50
|
| Rate for Payer: Multiplan Commercial |
$161.25
|
| Rate for Payer: Networks By Design Commercial |
$139.75
|
| Rate for Payer: Prime Health Services Commercial |
$182.75
|
| Rate for Payer: Riverside University Health System MISP |
$86.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$129.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$129.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$182.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.75
|
| Rate for Payer: Vantage Medical Group Senior |
$182.75
|
|
|
HC SENSORY INTEGRAT TECH 15 MIN MCAL
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
901300064
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$43.00 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Adventist Health Commercial |
$43.00
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Central Health Plan Commercial |
$172.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.00
|
| Rate for Payer: EPIC Health Plan Senior |
$86.00
|
| Rate for Payer: Galaxy Health WC |
$182.75
|
| Rate for Payer: Global Benefits Group Commercial |
$129.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$161.25
|
| Rate for Payer: Networks By Design Commercial |
$139.75
|
| Rate for Payer: Prime Health Services Commercial |
$182.75
|
|
|
HC SENSORY INTEGRAT TECH 15 MIN MCAL
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
901300064
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$88.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$122.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$182.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$118.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$161.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Central Health Plan Commercial |
$172.00
|
| Rate for Payer: Cigna of CA HMO |
$137.60
|
| Rate for Payer: Cigna of CA PPO |
$159.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$182.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$182.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.00
|
| Rate for Payer: EPIC Health Plan Senior |
$86.00
|
| Rate for Payer: Galaxy Health WC |
$182.75
|
| Rate for Payer: Global Benefits Group Commercial |
$129.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$150.50
|
| Rate for Payer: Multiplan Commercial |
$161.25
|
| Rate for Payer: Networks By Design Commercial |
$139.75
|
| Rate for Payer: Prime Health Services Commercial |
$182.75
|
| Rate for Payer: Riverside University Health System MISP |
$86.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$129.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$129.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$182.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.75
|
| Rate for Payer: Vantage Medical Group Senior |
$182.75
|
|
|
HC SENSORY INTEGRAT TECH 15 MIN OT
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
905104522
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$43.00 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Adventist Health Commercial |
$43.00
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Central Health Plan Commercial |
$172.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.00
|
| Rate for Payer: EPIC Health Plan Senior |
$86.00
|
| Rate for Payer: Galaxy Health WC |
$182.75
|
| Rate for Payer: Global Benefits Group Commercial |
$129.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$161.25
|
| Rate for Payer: Networks By Design Commercial |
$139.75
|
| Rate for Payer: Prime Health Services Commercial |
$182.75
|
|
|
HC SENSORY INTEGRAT TECH 15 MIN OT
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
905104522
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$88.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$122.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$182.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$118.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$161.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Central Health Plan Commercial |
$172.00
|
| Rate for Payer: Cigna of CA HMO |
$137.60
|
| Rate for Payer: Cigna of CA PPO |
$159.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$182.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$182.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.00
|
| Rate for Payer: EPIC Health Plan Senior |
$86.00
|
| Rate for Payer: Galaxy Health WC |
$182.75
|
| Rate for Payer: Global Benefits Group Commercial |
$129.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$150.50
|
| Rate for Payer: Multiplan Commercial |
$161.25
|
| Rate for Payer: Networks By Design Commercial |
$139.75
|
| Rate for Payer: Prime Health Services Commercial |
$182.75
|
| Rate for Payer: Riverside University Health System MISP |
$86.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$129.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$129.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$182.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.75
|
| Rate for Payer: Vantage Medical Group Senior |
$182.75
|
|
|
HC SENSORY INTEGRAT TECH 15 MIN PT
|
Facility
|
OP
|
$215.00
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
905103501
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$41.57 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$88.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$122.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$182.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$118.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$161.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Central Health Plan Commercial |
$172.00
|
| Rate for Payer: Cigna of CA HMO |
$137.60
|
| Rate for Payer: Cigna of CA PPO |
$159.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$182.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$182.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$182.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.00
|
| Rate for Payer: EPIC Health Plan Senior |
$86.00
|
| Rate for Payer: Galaxy Health WC |
$182.75
|
| Rate for Payer: Global Benefits Group Commercial |
$129.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$150.50
|
| Rate for Payer: Multiplan Commercial |
$161.25
|
| Rate for Payer: Networks By Design Commercial |
$139.75
|
| Rate for Payer: Prime Health Services Commercial |
$182.75
|
| Rate for Payer: Riverside University Health System MISP |
$86.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$129.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$129.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$182.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$182.75
|
| Rate for Payer: Vantage Medical Group Senior |
$182.75
|
|
|
HC SENSORY INTEGRAT TECH 15 MIN PT
|
Facility
|
IP
|
$215.00
|
|
|
Service Code
|
CPT 97533
|
| Hospital Charge Code |
905103501
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$43.00 |
| Max. Negotiated Rate |
$193.50 |
| Rate for Payer: Adventist Health Commercial |
$43.00
|
| Rate for Payer: Cash Price |
$96.75
|
| Rate for Payer: Central Health Plan Commercial |
$172.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$150.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$86.00
|
| Rate for Payer: EPIC Health Plan Senior |
$86.00
|
| Rate for Payer: Galaxy Health WC |
$182.75
|
| Rate for Payer: Global Benefits Group Commercial |
$129.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$193.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$136.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$126.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$161.25
|
| Rate for Payer: Networks By Design Commercial |
$139.75
|
| Rate for Payer: Prime Health Services Commercial |
$182.75
|
|
|
HC SENSORY NERVE CONDUCTION STUDY
|
Facility
|
IP
|
$237.00
|
|
| Hospital Charge Code |
900600258
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$47.40 |
| Max. Negotiated Rate |
$213.30 |
| Rate for Payer: Adventist Health Commercial |
$47.40
|
| Rate for Payer: Cash Price |
$106.65
|
| Rate for Payer: Central Health Plan Commercial |
$189.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.80
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$150.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.83
|
| 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 SENSORY NERVE CONDUCTION STUDY
|
Facility
|
OP
|
$237.00
|
|
| Hospital Charge Code |
900600258
|
|
Hospital Revenue Code
|
922
|
| Min. Negotiated Rate |
$47.40 |
| Max. Negotiated Rate |
$1,297.00 |
| Rate for Payer: Adventist Health Commercial |
$47.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$143.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$201.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$130.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$114.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$137.86
|
| Rate for Payer: Blue Shield of California Commercial |
$149.31
|
| Rate for Payer: Blue Shield of California EPN |
$94.09
|
| 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 |
$201.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$201.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$201.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.80
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$150.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$165.90
|
| 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: Riverside University Health System MISP |
$94.80
|
| 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 |
$1,297.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,024.00
|
| Rate for Payer: United Healthcare HMO Rider |
$776.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$711.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$201.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$201.45
|
| Rate for Payer: Vantage Medical Group Senior |
$201.45
|
|
|
HC SENSORY TEST ENDOSCOP SWALLOW
|
Facility
|
IP
|
$296.00
|
|
|
Service Code
|
CPT 92616
|
| Hospital Charge Code |
905601752
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$266.40 |
| Rate for Payer: Adventist Health Commercial |
$59.20
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Central Health Plan Commercial |
$236.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.40
|
| Rate for Payer: EPIC Health Plan Senior |
$118.40
|
| Rate for Payer: Galaxy Health WC |
$251.60
|
| Rate for Payer: Global Benefits Group Commercial |
$177.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$266.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$187.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$174.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.20
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
| Rate for Payer: Networks By Design Commercial |
$192.40
|
| Rate for Payer: Prime Health Services Commercial |
$251.60
|
|
|
HC SENSORY TEST ENDOSCOP SWALLOW
|
Facility
|
OP
|
$296.00
|
|
|
Service Code
|
CPT 92616
|
| Hospital Charge Code |
905601752
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$118.40 |
| Max. Negotiated Rate |
$581.97 |
| Rate for Payer: Adventist Health Commercial |
$121.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$581.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$251.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$162.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$222.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Central Health Plan Commercial |
$236.80
|
| Rate for Payer: Cigna of CA HMO |
$189.44
|
| Rate for Payer: Cigna of CA PPO |
$219.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$251.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$251.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$251.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.40
|
| Rate for Payer: EPIC Health Plan Senior |
$118.40
|
| Rate for Payer: Galaxy Health WC |
$251.60
|
| Rate for Payer: Global Benefits Group Commercial |
$177.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$266.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$203.68
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$187.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$225.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$174.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$121.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$207.20
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
| Rate for Payer: Networks By Design Commercial |
$192.40
|
| Rate for Payer: Prime Health Services Commercial |
$251.60
|
| Rate for Payer: Riverside University Health System MISP |
$118.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$177.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$177.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$251.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$251.60
|
| Rate for Payer: Vantage Medical Group Senior |
$251.60
|
|
|
HC SENSORY TEST ENDOSCOP SWALLOW MCAL
|
Facility
|
IP
|
$296.00
|
|
|
Service Code
|
CPT 92616
|
| Hospital Charge Code |
907000034
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$59.20 |
| Max. Negotiated Rate |
$266.40 |
| Rate for Payer: Adventist Health Commercial |
$59.20
|
| Rate for Payer: Cash Price |
$133.20
|
| Rate for Payer: Central Health Plan Commercial |
$236.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.40
|
| Rate for Payer: EPIC Health Plan Senior |
$118.40
|
| Rate for Payer: Galaxy Health WC |
$251.60
|
| Rate for Payer: Global Benefits Group Commercial |
$177.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$266.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$187.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$174.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.20
|
| Rate for Payer: Multiplan Commercial |
$222.00
|
| Rate for Payer: Networks By Design Commercial |
$192.40
|
| Rate for Payer: Prime Health Services Commercial |
$251.60
|
|
