|
HC SOM CHROMIUM
|
Facility
|
IP
|
$26.11
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
900911190
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$23.50 |
| Rate for Payer: Adventist Health Commercial |
$5.22
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Central Health Plan Commercial |
$20.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.44
|
| Rate for Payer: EPIC Health Plan Senior |
$10.44
|
| Rate for Payer: Galaxy Health WC |
$22.19
|
| Rate for Payer: Global Benefits Group Commercial |
$15.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$19.58
|
| Rate for Payer: Networks By Design Commercial |
$16.97
|
| Rate for Payer: Prime Health Services Commercial |
$22.19
|
|
|
HC SOM CHROMIUM URINE
|
Facility
|
OP
|
$26.11
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
900910731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$205.09 |
| Rate for Payer: Adventist Health Commercial |
$5.22
|
| Rate for Payer: Adventist Health Medi-Cal |
$20.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$148.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$147.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$205.09
|
| Rate for Payer: Blue Shield of California Commercial |
$16.45
|
| Rate for Payer: Blue Shield of California EPN |
$10.37
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Central Health Plan Commercial |
$20.89
|
| Rate for Payer: Cigna of CA HMO |
$16.71
|
| Rate for Payer: Cigna of CA PPO |
$19.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.46
|
| Rate for Payer: EPIC Health Plan Senior |
$22.31
|
| Rate for Payer: Galaxy Health WC |
$22.19
|
| Rate for Payer: Global Benefits Group Commercial |
$15.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$33.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.18
|
| Rate for Payer: Multiplan Commercial |
$19.58
|
| Rate for Payer: Networks By Design Commercial |
$16.97
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20.28
|
| Rate for Payer: Prime Health Services Commercial |
$22.19
|
| Rate for Payer: Prime Health Services Medicare |
$21.50
|
| Rate for Payer: Riverside University Health System MISP |
$22.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.43
|
| Rate for Payer: United Healthcare All Other HMO |
$16.43
|
| Rate for Payer: United Healthcare HMO Rider |
$16.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.43
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.31
|
| Rate for Payer: Vantage Medical Group Senior |
$20.28
|
|
|
HC SOM CHROMIUM URINE
|
Facility
|
IP
|
$26.11
|
|
|
Service Code
|
CPT 82495
|
| Hospital Charge Code |
900910731
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$23.50 |
| Rate for Payer: Adventist Health Commercial |
$5.22
|
| Rate for Payer: Cash Price |
$26.11
|
| Rate for Payer: Central Health Plan Commercial |
$20.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.44
|
| Rate for Payer: EPIC Health Plan Senior |
$10.44
|
| Rate for Payer: Galaxy Health WC |
$22.19
|
| Rate for Payer: Global Benefits Group Commercial |
$15.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.22
|
| Rate for Payer: Multiplan Commercial |
$19.58
|
| Rate for Payer: Networks By Design Commercial |
$16.97
|
| Rate for Payer: Prime Health Services Commercial |
$22.19
|
|
|
HC SOM CHROMOGRANIN A
|
Facility
|
IP
|
$17.65
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
900911458
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$15.88 |
| Rate for Payer: Adventist Health Commercial |
$3.53
|
| Rate for Payer: Cash Price |
$17.65
|
| Rate for Payer: Central Health Plan Commercial |
$14.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.06
|
| Rate for Payer: EPIC Health Plan Senior |
$7.06
|
| Rate for Payer: Galaxy Health WC |
$15.00
|
| Rate for Payer: Global Benefits Group Commercial |
$10.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.53
|
| Rate for Payer: Multiplan Commercial |
$13.24
|
| Rate for Payer: Networks By Design Commercial |
$11.47
|
| Rate for Payer: Prime Health Services Commercial |
$15.00
|
|
|
HC SOM CHROMOGRANIN A
|
Facility
|
OP
|
$17.65
|
|
|
Service Code
|
CPT 86316
|
| Hospital Charge Code |
900911458
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.53 |
| Max. Negotiated Rate |
$210.47 |
| Rate for Payer: Adventist Health Commercial |
$3.53
|
| Rate for Payer: Adventist Health Medi-Cal |
$20.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$152.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$151.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$210.47
|
| Rate for Payer: Blue Shield of California Commercial |
$11.12
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Cash Price |
$17.65
|
| Rate for Payer: Cash Price |
$17.65
|
| Rate for Payer: Central Health Plan Commercial |
$14.12
|
| Rate for Payer: Cigna of CA HMO |
$11.30
|
| Rate for Payer: Cigna of CA PPO |
$13.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.34
|
| Rate for Payer: EPIC Health Plan Senior |
$22.89
|
| Rate for Payer: Galaxy Health WC |
$15.00
|
| Rate for Payer: Global Benefits Group Commercial |
$10.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$34.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.89
|
| Rate for Payer: Multiplan Commercial |
$13.24
|
| Rate for Payer: Networks By Design Commercial |
$11.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$20.81
|
| Rate for Payer: Prime Health Services Commercial |
$15.00
|
| Rate for Payer: Prime Health Services Medicare |
$22.06
|
| Rate for Payer: Riverside University Health System MISP |
$22.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.86
|
| Rate for Payer: United Healthcare All Other HMO |
$16.86
|
| Rate for Payer: United Healthcare HMO Rider |
$16.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.86
|
| Rate for Payer: Upland Medical Group Pediatric |
$20.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.89
|
| Rate for Payer: Vantage Medical Group Senior |
$20.81
|
|
|
HC SOM CHROMOSOMAL MICROARRAY
|
Facility
|
IP
|
$1,728.62
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
900914668
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$345.72 |
| Max. Negotiated Rate |
$1,555.76 |
| Rate for Payer: Adventist Health Commercial |
$345.72
|
| Rate for Payer: Cash Price |
$1,728.62
|
| Rate for Payer: Central Health Plan Commercial |
$1,382.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$691.45
|
| Rate for Payer: EPIC Health Plan Senior |
$691.45
|
| Rate for Payer: Galaxy Health WC |
$1,469.33
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,555.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,097.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,019.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$345.72
|
| Rate for Payer: Multiplan Commercial |
$1,296.46
|
| Rate for Payer: Networks By Design Commercial |
$1,123.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.33
|
|
|
HC SOM CHROMOSOMAL MICROARRAY
|
Facility
|
OP
|
$1,728.62
|
|
|
Service Code
|
CPT 81229
|
| Hospital Charge Code |
900914668
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$85.76 |
| Max. Negotiated Rate |
$1,914.00 |
| Rate for Payer: Adventist Health Commercial |
$345.72
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,160.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,126.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,740.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,276.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,160.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$85.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$119.23
|
| Rate for Payer: Blue Shield of California Commercial |
$1,089.03
|
| Rate for Payer: Blue Shield of California EPN |
$686.26
|
| Rate for Payer: Cash Price |
$1,728.62
|
| Rate for Payer: Cash Price |
$1,728.62
|
| Rate for Payer: Central Health Plan Commercial |
$1,382.90
|
| Rate for Payer: Cigna of CA HMO |
$1,106.32
|
| Rate for Payer: Cigna of CA PPO |
$1,279.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,740.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,276.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,160.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,210.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,914.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1,276.00
|
| Rate for Payer: Galaxy Health WC |
$1,469.33
|
| Rate for Payer: Global Benefits Group Commercial |
$1,037.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,555.76
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,902.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$929.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,160.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,097.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,026.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,624.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,728.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,554.40
|
| Rate for Payer: Multiplan Commercial |
$1,296.46
|
| Rate for Payer: Networks By Design Commercial |
$1,123.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,160.00
|
| Rate for Payer: Prime Health Services Commercial |
$1,469.33
|
| Rate for Payer: Prime Health Services Medicare |
$1,229.60
|
| Rate for Payer: Riverside University Health System MISP |
$1,276.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,037.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,037.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$939.60
|
| Rate for Payer: United Healthcare All Other HMO |
$939.60
|
| Rate for Payer: United Healthcare HMO Rider |
$939.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$939.60
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,160.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,740.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,276.00
|
| Rate for Payer: Vantage Medical Group Senior |
$1,160.00
|
|
|
HC SOM CHROMOSOME ANALYSIS BREAKAGE
|
Facility
|
OP
|
$243.11
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912554
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$218.80 |
| Rate for Payer: Adventist Health Commercial |
$48.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$166.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$206.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$133.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$182.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.95
|
| Rate for Payer: Blue Shield of California Commercial |
$153.16
|
| Rate for Payer: Blue Shield of California EPN |
$96.51
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Central Health Plan Commercial |
$194.49
|
| Rate for Payer: Cigna of CA HMO |
$155.59
|
| Rate for Payer: Cigna of CA PPO |
$179.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$206.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$206.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$206.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$170.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.24
|
| Rate for Payer: EPIC Health Plan Senior |
$97.24
|
| Rate for Payer: Galaxy Health WC |
$206.64
|
| Rate for Payer: Global Benefits Group Commercial |
$145.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$154.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$143.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$170.18
|
| Rate for Payer: Multiplan Commercial |
$182.33
|
| Rate for Payer: Networks By Design Commercial |
$158.02
|
| Rate for Payer: Prime Health Services Commercial |
$206.64
|
| Rate for Payer: Riverside University Health System MISP |
$97.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$145.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$145.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$206.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$206.64
|
| Rate for Payer: Vantage Medical Group Senior |
$206.64
|
|
|
HC SOM CHROMOSOME ANALYSIS BREAKAGE
|
Facility
|
IP
|
$243.11
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912554
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$48.62 |
| Max. Negotiated Rate |
$218.80 |
| Rate for Payer: Adventist Health Commercial |
$48.62
|
| Rate for Payer: Cash Price |
$243.11
|
| Rate for Payer: Central Health Plan Commercial |
$194.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$170.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.24
|
| Rate for Payer: EPIC Health Plan Senior |
$97.24
|
| Rate for Payer: Galaxy Health WC |
$206.64
|
| Rate for Payer: Global Benefits Group Commercial |
$145.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$218.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$154.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$143.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.62
|
| Rate for Payer: Multiplan Commercial |
$182.33
|
| Rate for Payer: Networks By Design Commercial |
$158.02
|
| Rate for Payer: Prime Health Services Commercial |
$206.64
|
|
|
HC SOM CHROMOSOME ANALYSIS MARROW
|
Facility
|
OP
|
$950.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910601
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Adventist Health Commercial |
$190.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$166.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$807.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$522.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$712.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.95
|
| Rate for Payer: Blue Shield of California Commercial |
$598.50
|
| Rate for Payer: Blue Shield of California EPN |
$377.15
|
| Rate for Payer: Cash Price |
$950.00
|
| Rate for Payer: Cash Price |
$950.00
|
| Rate for Payer: Central Health Plan Commercial |
$760.00
|
| Rate for Payer: Cigna of CA HMO |
$608.00
|
| Rate for Payer: Cigna of CA PPO |
$703.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$807.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$807.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$807.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$665.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.00
|
| Rate for Payer: EPIC Health Plan Senior |
$380.00
|
| Rate for Payer: Galaxy Health WC |
$807.50
|
| Rate for Payer: Global Benefits Group Commercial |
$570.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$855.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$603.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$560.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$665.00
|
| Rate for Payer: Multiplan Commercial |
$712.50
|
| Rate for Payer: Networks By Design Commercial |
$617.50
|
| Rate for Payer: Prime Health Services Commercial |
$807.50
|
| Rate for Payer: Riverside University Health System MISP |
$380.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$570.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$570.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$807.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$807.50
|
| Rate for Payer: Vantage Medical Group Senior |
$807.50
|
|
|
HC SOM CHROMOSOME ANALYSIS MARROW
|
Facility
|
IP
|
$950.00
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910601
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$190.00 |
| Max. Negotiated Rate |
$855.00 |
| Rate for Payer: Adventist Health Commercial |
$190.00
|
| Rate for Payer: Cash Price |
$950.00
|
| Rate for Payer: Central Health Plan Commercial |
$760.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$665.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.00
|
| Rate for Payer: EPIC Health Plan Senior |
$380.00
|
| Rate for Payer: Galaxy Health WC |
$807.50
|
| Rate for Payer: Global Benefits Group Commercial |
$570.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$855.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$603.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$560.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.00
|
| Rate for Payer: Multiplan Commercial |
$712.50
|
| Rate for Payer: Networks By Design Commercial |
$617.50
|
| Rate for Payer: Prime Health Services Commercial |
$807.50
|
|
|
HC SOM CHROMOSOME ANALYSIS WHOLE BLOOD
|
Facility
|
IP
|
$315.45
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910752
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$63.09 |
| Max. Negotiated Rate |
$283.90 |
| Rate for Payer: Adventist Health Commercial |
$63.09
|
| Rate for Payer: Cash Price |
$315.45
|
| Rate for Payer: Central Health Plan Commercial |
$252.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$220.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.18
|
| Rate for Payer: EPIC Health Plan Senior |
$126.18
|
| Rate for Payer: Galaxy Health WC |
$268.13
|
| Rate for Payer: Global Benefits Group Commercial |
$189.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$283.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$200.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$186.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.09
|
| Rate for Payer: Multiplan Commercial |
$236.59
|
| Rate for Payer: Networks By Design Commercial |
$205.04
|
| Rate for Payer: Prime Health Services Commercial |
$268.13
|
|
|
HC SOM CHROMOSOME ANALYSIS WHOLE BLOOD
|
Facility
|
OP
|
$315.45
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900910752
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$283.90 |
| Rate for Payer: Adventist Health Commercial |
$63.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$166.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$268.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$173.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$236.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.95
|
| Rate for Payer: Blue Shield of California Commercial |
$198.73
|
| Rate for Payer: Blue Shield of California EPN |
$125.23
|
| Rate for Payer: Cash Price |
$315.45
|
| Rate for Payer: Cash Price |
$315.45
|
| Rate for Payer: Central Health Plan Commercial |
$252.36
|
| Rate for Payer: Cigna of CA HMO |
$201.89
|
| Rate for Payer: Cigna of CA PPO |
$233.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$268.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$268.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$268.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$220.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$126.18
|
| Rate for Payer: EPIC Health Plan Senior |
$126.18
|
| Rate for Payer: Galaxy Health WC |
$268.13
|
| Rate for Payer: Global Benefits Group Commercial |
$189.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$283.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$200.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$186.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$220.81
|
| Rate for Payer: Multiplan Commercial |
$236.59
|
| Rate for Payer: Networks By Design Commercial |
$205.04
|
| Rate for Payer: Prime Health Services Commercial |
$268.13
|
| Rate for Payer: Riverside University Health System MISP |
$126.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$189.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$189.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$268.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$268.13
|
| Rate for Payer: Vantage Medical Group Senior |
$268.13
|
|
|
HC SOM CHROMOSOMES CHORIONIC VILLUS
|
Facility
|
IP
|
$308.52
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912549
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$61.70 |
| Max. Negotiated Rate |
$277.67 |
| Rate for Payer: Adventist Health Commercial |
$61.70
|
| Rate for Payer: Cash Price |
$308.52
|
| Rate for Payer: Central Health Plan Commercial |
$246.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$215.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.41
|
| Rate for Payer: EPIC Health Plan Senior |
$123.41
|
| Rate for Payer: Galaxy Health WC |
$262.24
|
| Rate for Payer: Global Benefits Group Commercial |
$185.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$195.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.70
|
| Rate for Payer: Multiplan Commercial |
$231.39
|
| Rate for Payer: Networks By Design Commercial |
$200.54
|
| Rate for Payer: Prime Health Services Commercial |
$262.24
|
|
|
HC SOM CHROMOSOMES CHORIONIC VILLUS
|
Facility
|
OP
|
$308.52
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912549
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$23.43 |
| Max. Negotiated Rate |
$277.67 |
| Rate for Payer: Adventist Health Commercial |
$61.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$166.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$262.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$169.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$231.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.95
|
| Rate for Payer: Blue Shield of California Commercial |
$194.37
|
| Rate for Payer: Blue Shield of California EPN |
$122.48
|
| Rate for Payer: Cash Price |
$308.52
|
| Rate for Payer: Cash Price |
$308.52
|
| Rate for Payer: Central Health Plan Commercial |
$246.82
|
| Rate for Payer: Cigna of CA HMO |
$197.45
|
| Rate for Payer: Cigna of CA PPO |
$228.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$262.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$262.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$262.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$215.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.41
|
| Rate for Payer: EPIC Health Plan Senior |
$123.41
|
| Rate for Payer: Galaxy Health WC |
$262.24
|
| Rate for Payer: Global Benefits Group Commercial |
$185.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.67
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$195.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$215.96
|
| Rate for Payer: Multiplan Commercial |
$231.39
|
| Rate for Payer: Networks By Design Commercial |
$200.54
|
| Rate for Payer: Prime Health Services Commercial |
$262.24
|
| Rate for Payer: Riverside University Health System MISP |
$123.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$185.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$185.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$262.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$262.24
|
| Rate for Payer: Vantage Medical Group Senior |
$262.24
|
|
|
HC SOM CHROMOSOMES LYMPHOID
|
Facility
|
IP
|
$36.56
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912548
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$7.31 |
| Max. Negotiated Rate |
$32.90 |
| Rate for Payer: Adventist Health Commercial |
$7.31
|
| Rate for Payer: Cash Price |
$36.56
|
| Rate for Payer: Central Health Plan Commercial |
$29.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.62
|
| Rate for Payer: EPIC Health Plan Senior |
$14.62
|
| Rate for Payer: Galaxy Health WC |
$31.08
|
| Rate for Payer: Global Benefits Group Commercial |
$21.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.31
|
| Rate for Payer: Multiplan Commercial |
$27.42
|
| Rate for Payer: Networks By Design Commercial |
$23.76
|
| Rate for Payer: Prime Health Services Commercial |
$31.08
|
|
|
HC SOM CHROMOSOMES LYMPHOID
|
Facility
|
OP
|
$36.56
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912548
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$7.31 |
| Max. Negotiated Rate |
$188.95 |
| Rate for Payer: Adventist Health Commercial |
$7.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$166.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.42
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.95
|
| Rate for Payer: Blue Shield of California Commercial |
$23.03
|
| Rate for Payer: Blue Shield of California EPN |
$14.51
|
| Rate for Payer: Cash Price |
$36.56
|
| Rate for Payer: Cash Price |
$36.56
|
| Rate for Payer: Central Health Plan Commercial |
$29.25
|
| Rate for Payer: Cigna of CA HMO |
$23.40
|
| Rate for Payer: Cigna of CA PPO |
$27.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.62
|
| Rate for Payer: EPIC Health Plan Senior |
$14.62
|
| Rate for Payer: Galaxy Health WC |
$31.08
|
| Rate for Payer: Global Benefits Group Commercial |
$21.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$25.59
|
| Rate for Payer: Multiplan Commercial |
$27.42
|
| Rate for Payer: Networks By Design Commercial |
$23.76
|
| Rate for Payer: Prime Health Services Commercial |
$31.08
|
| Rate for Payer: Riverside University Health System MISP |
$14.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.08
|
| Rate for Payer: Vantage Medical Group Senior |
$31.08
|
|
|
HC SOM CHROMOSOMES SKIN BIOPSY
|
Facility
|
IP
|
$90.50
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912547
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$81.45 |
| Rate for Payer: Adventist Health Commercial |
$18.10
|
| Rate for Payer: Cash Price |
$90.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.20
|
| Rate for Payer: EPIC Health Plan Senior |
$36.20
|
| Rate for Payer: Galaxy Health WC |
$76.92
|
| Rate for Payer: Global Benefits Group Commercial |
$54.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$53.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.10
|
| Rate for Payer: Multiplan Commercial |
$67.88
|
| Rate for Payer: Networks By Design Commercial |
$58.83
|
| Rate for Payer: Prime Health Services Commercial |
$76.92
|
|
|
HC SOM CHROMOSOMES SKIN BIOPSY
|
Facility
|
OP
|
$90.50
|
|
|
Service Code
|
CPT 88291
|
| Hospital Charge Code |
900912547
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$18.10 |
| Max. Negotiated Rate |
$188.95 |
| Rate for Payer: Adventist Health Commercial |
$18.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$166.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$76.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$49.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$67.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$135.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$188.95
|
| Rate for Payer: Blue Shield of California Commercial |
$57.02
|
| Rate for Payer: Blue Shield of California EPN |
$35.93
|
| Rate for Payer: Cash Price |
$90.50
|
| Rate for Payer: Cash Price |
$90.50
|
| Rate for Payer: Central Health Plan Commercial |
$72.40
|
| Rate for Payer: Cigna of CA HMO |
$57.92
|
| Rate for Payer: Cigna of CA PPO |
$66.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$76.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$76.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.20
|
| Rate for Payer: EPIC Health Plan Senior |
$36.20
|
| Rate for Payer: Galaxy Health WC |
$76.92
|
| Rate for Payer: Global Benefits Group Commercial |
$54.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$53.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$63.35
|
| Rate for Payer: Multiplan Commercial |
$67.88
|
| Rate for Payer: Networks By Design Commercial |
$58.83
|
| Rate for Payer: Prime Health Services Commercial |
$76.92
|
| Rate for Payer: Riverside University Health System MISP |
$36.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$54.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$54.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.19
|
| Rate for Payer: United Healthcare All Other HMO |
$27.19
|
| Rate for Payer: United Healthcare HMO Rider |
$27.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$76.92
|
| Rate for Payer: Vantage Medical Group Senior |
$76.92
|
|
|
HC SOM CHROMOSOMES SKIN BIOPSY CULTURE
|
Facility
|
OP
|
$385.50
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900915431
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$77.10 |
| Max. Negotiated Rate |
$1,208.26 |
| Rate for Payer: Adventist Health Commercial |
$77.10
|
| Rate for Payer: Adventist Health Medi-Cal |
$140.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,032.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$140.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$869.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,208.26
|
| Rate for Payer: Blue Shield of California Commercial |
$242.87
|
| Rate for Payer: Blue Shield of California EPN |
$153.04
|
| Rate for Payer: Cash Price |
$385.50
|
| Rate for Payer: Cash Price |
$385.50
|
| Rate for Payer: Central Health Plan Commercial |
$308.40
|
| Rate for Payer: Cigna of CA HMO |
$246.72
|
| Rate for Payer: Cigna of CA PPO |
$285.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$154.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$140.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$269.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.20
|
| Rate for Payer: EPIC Health Plan Senior |
$154.80
|
| Rate for Payer: Galaxy Health WC |
$327.68
|
| Rate for Payer: Global Benefits Group Commercial |
$231.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$346.95
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$230.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$215.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$140.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$244.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$237.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$197.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$188.58
|
| Rate for Payer: Multiplan Commercial |
$289.12
|
| Rate for Payer: Networks By Design Commercial |
$250.57
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$140.73
|
| Rate for Payer: Prime Health Services Commercial |
$327.68
|
| Rate for Payer: Prime Health Services Medicare |
$149.17
|
| Rate for Payer: Riverside University Health System MISP |
$154.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$231.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$231.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.99
|
| Rate for Payer: United Healthcare All Other HMO |
$113.99
|
| Rate for Payer: United Healthcare HMO Rider |
$113.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.99
|
| Rate for Payer: Upland Medical Group Pediatric |
$140.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Vantage Medical Group Senior |
$140.73
|
|
|
HC SOM CHROMOSOMES SKIN BIOPSY CULTURE
|
Facility
|
IP
|
$385.50
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900915431
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$77.10 |
| Max. Negotiated Rate |
$346.95 |
| Rate for Payer: Adventist Health Commercial |
$77.10
|
| Rate for Payer: Cash Price |
$385.50
|
| Rate for Payer: Central Health Plan Commercial |
$308.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$269.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.20
|
| Rate for Payer: EPIC Health Plan Senior |
$154.20
|
| Rate for Payer: Galaxy Health WC |
$327.68
|
| Rate for Payer: Global Benefits Group Commercial |
$231.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$346.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$244.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$227.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.10
|
| Rate for Payer: Multiplan Commercial |
$289.12
|
| Rate for Payer: Networks By Design Commercial |
$250.57
|
| Rate for Payer: Prime Health Services Commercial |
$327.68
|
|
|
HC SOM CHRONIC URTICARIA INDEX
|
Facility
|
OP
|
$160.00
|
|
|
Service Code
|
CPT 86343
|
| Hospital Charge Code |
900912840
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Adventist Health Commercial |
$32.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$87.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$121.95
|
| Rate for Payer: Blue Shield of California Commercial |
$100.80
|
| Rate for Payer: Blue Shield of California EPN |
$63.52
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Central Health Plan Commercial |
$128.00
|
| Rate for Payer: Cigna of CA HMO |
$102.40
|
| Rate for Payer: Cigna of CA PPO |
$118.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$112.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.56
|
| Rate for Payer: EPIC Health Plan Senior |
$13.71
|
| 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: Heritage Provider Network Commercial/Senior |
$20.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$101.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$16.70
|
| Rate for Payer: Multiplan Commercial |
$120.00
|
| Rate for Payer: Networks By Design Commercial |
$104.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.46
|
| Rate for Payer: Prime Health Services Commercial |
$136.00
|
| Rate for Payer: Prime Health Services Medicare |
$13.21
|
| Rate for Payer: Riverside University Health System MISP |
$13.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$96.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$96.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.09
|
| Rate for Payer: United Healthcare All Other HMO |
$10.09
|
| Rate for Payer: United Healthcare HMO Rider |
$10.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.09
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.71
|
| Rate for Payer: Vantage Medical Group Senior |
$12.46
|
|
|
HC SOM CHRONIC URTICARIA INDEX
|
Facility
|
IP
|
$160.00
|
|
|
Service Code
|
CPT 86343
|
| Hospital Charge Code |
900912840
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$32.00 |
| Max. Negotiated Rate |
$144.00 |
| Rate for Payer: Adventist Health Commercial |
$32.00
|
| Rate for Payer: Cash Price |
$160.00
|
| Rate for Payer: Central Health Plan Commercial |
$128.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$112.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.00
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$101.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$94.40
|
| 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 SOM CHRTI CULTURE 02
|
Facility
|
OP
|
$173.04
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900915283
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.61 |
| Max. Negotiated Rate |
$1,208.26 |
| Rate for Payer: Adventist Health Commercial |
$34.61
|
| Rate for Payer: Adventist Health Medi-Cal |
$140.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,032.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$211.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$140.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$869.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,208.26
|
| Rate for Payer: Blue Shield of California Commercial |
$109.02
|
| Rate for Payer: Blue Shield of California EPN |
$68.70
|
| Rate for Payer: Cash Price |
$173.04
|
| Rate for Payer: Cash Price |
$173.04
|
| Rate for Payer: Central Health Plan Commercial |
$138.43
|
| Rate for Payer: Cigna of CA HMO |
$110.75
|
| Rate for Payer: Cigna of CA PPO |
$128.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$211.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$154.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$140.73
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$121.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.20
|
| Rate for Payer: EPIC Health Plan Senior |
$154.80
|
| Rate for Payer: Galaxy Health WC |
$147.08
|
| Rate for Payer: Global Benefits Group Commercial |
$103.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$155.74
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$230.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$215.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$140.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$109.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$237.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$197.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$188.58
|
| Rate for Payer: Multiplan Commercial |
$129.78
|
| Rate for Payer: Networks By Design Commercial |
$112.48
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$140.73
|
| Rate for Payer: Prime Health Services Commercial |
$147.08
|
| Rate for Payer: Prime Health Services Medicare |
$149.17
|
| Rate for Payer: Riverside University Health System MISP |
$154.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$103.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$103.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$113.99
|
| Rate for Payer: United Healthcare All Other HMO |
$113.99
|
| Rate for Payer: United Healthcare HMO Rider |
$113.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$113.99
|
| Rate for Payer: Upland Medical Group Pediatric |
$140.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$211.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$154.80
|
| Rate for Payer: Vantage Medical Group Senior |
$140.73
|
|
|
HC SOM CHRTI CULTURE 02
|
Facility
|
IP
|
$173.04
|
|
|
Service Code
|
CPT 88233
|
| Hospital Charge Code |
900915283
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$34.61 |
| Max. Negotiated Rate |
$155.74 |
| Rate for Payer: Adventist Health Commercial |
$34.61
|
| Rate for Payer: Cash Price |
$173.04
|
| Rate for Payer: Central Health Plan Commercial |
$138.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$121.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.22
|
| Rate for Payer: EPIC Health Plan Senior |
$69.22
|
| Rate for Payer: Galaxy Health WC |
$147.08
|
| Rate for Payer: Global Benefits Group Commercial |
$103.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$155.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$109.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$102.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.61
|
| Rate for Payer: Multiplan Commercial |
$129.78
|
| Rate for Payer: Networks By Design Commercial |
$112.48
|
| Rate for Payer: Prime Health Services Commercial |
$147.08
|
|
