|
HC SOM GLUTAMIC ACID DECARBOXYLASE AB
|
Facility
|
OP
|
$24.57
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900911121
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$4.91 |
| Max. Negotiated Rate |
$155.52 |
| Rate for Payer: Adventist Health Commercial |
$4.91
|
| Rate for Payer: Adventist Health Medi-Cal |
$23.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$121.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$111.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$155.52
|
| Rate for Payer: Blue Shield of California Commercial |
$15.48
|
| Rate for Payer: Blue Shield of California EPN |
$9.75
|
| Rate for Payer: Cash Price |
$24.57
|
| Rate for Payer: Cash Price |
$24.57
|
| Rate for Payer: Central Health Plan Commercial |
$19.66
|
| Rate for Payer: Cigna of CA HMO |
$15.72
|
| Rate for Payer: Cigna of CA PPO |
$18.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.89
|
| Rate for Payer: EPIC Health Plan Senior |
$25.93
|
| Rate for Payer: Galaxy Health WC |
$20.88
|
| Rate for Payer: Global Benefits Group Commercial |
$14.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.11
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$38.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$23.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$31.58
|
| Rate for Payer: Multiplan Commercial |
$18.43
|
| Rate for Payer: Networks By Design Commercial |
$15.97
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$23.57
|
| Rate for Payer: Prime Health Services Commercial |
$20.88
|
| Rate for Payer: Prime Health Services Medicare |
$24.98
|
| Rate for Payer: Riverside University Health System MISP |
$25.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.09
|
| Rate for Payer: United Healthcare All Other HMO |
$19.09
|
| Rate for Payer: United Healthcare HMO Rider |
$19.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.09
|
| Rate for Payer: Upland Medical Group Pediatric |
$23.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$23.57
|
|
|
HC SOM GROWTH HORMONE
|
Facility
|
OP
|
$10.80
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
900911488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$168.52 |
| Rate for Payer: Adventist Health Commercial |
$2.16
|
| Rate for Payer: Adventist Health Medi-Cal |
$16.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$122.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$121.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$168.52
|
| Rate for Payer: Blue Shield of California Commercial |
$6.80
|
| Rate for Payer: Blue Shield of California EPN |
$4.29
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$8.64
|
| Rate for Payer: Cigna of CA HMO |
$6.91
|
| Rate for Payer: Cigna of CA PPO |
$7.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.34
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.51
|
| Rate for Payer: EPIC Health Plan Senior |
$18.34
|
| Rate for Payer: Galaxy Health WC |
$9.18
|
| Rate for Payer: Global Benefits Group Commercial |
$6.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.72
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$27.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$28.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.34
|
| Rate for Payer: Multiplan Commercial |
$8.10
|
| Rate for Payer: Networks By Design Commercial |
$7.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16.67
|
| Rate for Payer: Prime Health Services Commercial |
$9.18
|
| Rate for Payer: Prime Health Services Medicare |
$17.67
|
| Rate for Payer: Riverside University Health System MISP |
$18.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.50
|
| Rate for Payer: United Healthcare All Other HMO |
$13.50
|
| Rate for Payer: United Healthcare HMO Rider |
$13.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$16.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.34
|
| Rate for Payer: Vantage Medical Group Senior |
$16.67
|
|
|
HC SOM GROWTH HORMONE
|
Facility
|
IP
|
$10.80
|
|
|
Service Code
|
CPT 83003
|
| Hospital Charge Code |
900911488
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$9.72 |
| Rate for Payer: Adventist Health Commercial |
$2.16
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$8.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.32
|
| Rate for Payer: EPIC Health Plan Senior |
$4.32
|
| Rate for Payer: Galaxy Health WC |
$9.18
|
| Rate for Payer: Global Benefits Group Commercial |
$6.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Multiplan Commercial |
$8.10
|
| Rate for Payer: Networks By Design Commercial |
$7.02
|
| Rate for Payer: Prime Health Services Commercial |
$9.18
|
|
|
HC SOM HALDOL(HALOPERIDOL) LEVEL
|
Facility
|
OP
|
$56.38
|
|
|
Service Code
|
CPT 80173
|
| Hospital Charge Code |
900911401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$147.14 |
| Rate for Payer: Adventist Health Commercial |
$11.28
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$106.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$147.14
|
| Rate for Payer: Blue Shield of California Commercial |
$35.52
|
| Rate for Payer: Blue Shield of California EPN |
$22.38
|
| Rate for Payer: Cash Price |
$56.38
|
| Rate for Payer: Cash Price |
$56.38
|
| Rate for Payer: Central Health Plan Commercial |
$45.10
|
| Rate for Payer: Cigna of CA HMO |
$36.08
|
| Rate for Payer: Cigna of CA PPO |
$41.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.04
|
| Rate for Payer: EPIC Health Plan Senior |
$17.36
|
| Rate for Payer: Galaxy Health WC |
$47.92
|
| Rate for Payer: Global Benefits Group Commercial |
$33.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.74
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$25.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21.15
|
| Rate for Payer: Multiplan Commercial |
$42.28
|
| Rate for Payer: Networks By Design Commercial |
$36.65
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.78
|
| Rate for Payer: Prime Health Services Commercial |
$47.92
|
| Rate for Payer: Prime Health Services Medicare |
$16.73
|
| Rate for Payer: Riverside University Health System MISP |
$17.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.78
|
| Rate for Payer: United Healthcare All Other HMO |
$12.78
|
| Rate for Payer: United Healthcare HMO Rider |
$12.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.78
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.36
|
| Rate for Payer: Vantage Medical Group Senior |
$15.78
|
|
|
HC SOM HALDOL(HALOPERIDOL) LEVEL
|
Facility
|
IP
|
$56.38
|
|
|
Service Code
|
CPT 80173
|
| Hospital Charge Code |
900911401
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$50.74 |
| Rate for Payer: Adventist Health Commercial |
$11.28
|
| Rate for Payer: Cash Price |
$56.38
|
| Rate for Payer: Central Health Plan Commercial |
$45.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.55
|
| Rate for Payer: EPIC Health Plan Senior |
$22.55
|
| Rate for Payer: Galaxy Health WC |
$47.92
|
| Rate for Payer: Global Benefits Group Commercial |
$33.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$35.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Multiplan Commercial |
$42.28
|
| Rate for Payer: Networks By Design Commercial |
$36.65
|
| Rate for Payer: Prime Health Services Commercial |
$47.92
|
|
|
HC SOM HANDLING FEE
|
Facility
|
IP
|
$35.00
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
900913932
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.00 |
| Max. Negotiated Rate |
$31.50 |
| Rate for Payer: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Central Health Plan Commercial |
$28.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14.00
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: Networks By Design Commercial |
$22.75
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
|
|
HC SOM HANDLING FEE
|
Facility
|
OP
|
$35.00
|
|
|
Service Code
|
CPT 99001
|
| Hospital Charge Code |
900913932
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$5.33 |
| Max. Negotiated Rate |
$99.21 |
| Rate for Payer: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Adventist Health Commercial |
$7.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$71.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$71.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$99.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$99.21
|
| Rate for Payer: Blue Shield of California Commercial |
$24.57
|
| Rate for Payer: Blue Shield of California Commercial |
$22.05
|
| Rate for Payer: Blue Shield of California EPN |
$15.48
|
| Rate for Payer: Blue Shield of California EPN |
$13.89
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$39.00
|
| Rate for Payer: Cash Price |
$35.00
|
| Rate for Payer: Central Health Plan Commercial |
$31.20
|
| Rate for Payer: Central Health Plan Commercial |
$28.00
|
| Rate for Payer: Cigna of CA HMO |
$24.96
|
| Rate for Payer: Cigna of CA HMO |
$22.40
|
| Rate for Payer: Cigna of CA PPO |
$28.86
|
| Rate for Payer: Cigna of CA PPO |
$25.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$15.60
|
| Rate for Payer: Galaxy Health WC |
$33.15
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Global Benefits Group Commercial |
$23.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$26.25
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
| Rate for Payer: Networks By Design Commercial |
$22.75
|
| Rate for Payer: Networks By Design Commercial |
$25.35
|
| Rate for Payer: Prime Health Services Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
| Rate for Payer: Riverside University Health System MISP |
$15.60
|
| Rate for Payer: Riverside University Health System MISP |
$14.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.33
|
| Rate for Payer: United Healthcare All Other HMO |
$5.33
|
| Rate for Payer: United Healthcare All Other HMO |
$5.33
|
| Rate for Payer: United Healthcare HMO Rider |
$5.33
|
| Rate for Payer: United Healthcare HMO Rider |
$5.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.15
|
| Rate for Payer: Vantage Medical Group Senior |
$33.15
|
| Rate for Payer: Vantage Medical Group Senior |
$29.75
|
|
|
HC SOM HBEL ELECTROPHORESIS SUMMARY INTERP
|
Facility
|
OP
|
$77.25
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
900915460
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$10.42 |
| Max. Negotiated Rate |
$110.58 |
| Rate for Payer: Adventist Health Commercial |
$15.45
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$94.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$79.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.58
|
| Rate for Payer: Blue Shield of California Commercial |
$48.67
|
| Rate for Payer: Blue Shield of California EPN |
$30.67
|
| Rate for Payer: Cash Price |
$77.25
|
| Rate for Payer: Cash Price |
$77.25
|
| Rate for Payer: Central Health Plan Commercial |
$61.80
|
| Rate for Payer: Cigna of CA HMO |
$49.44
|
| Rate for Payer: Cigna of CA PPO |
$57.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.24
|
| Rate for Payer: EPIC Health Plan Senior |
$14.16
|
| Rate for Payer: Galaxy Health WC |
$65.66
|
| Rate for Payer: Global Benefits Group Commercial |
$46.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.53
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.25
|
| Rate for Payer: Multiplan Commercial |
$57.94
|
| Rate for Payer: Networks By Design Commercial |
$50.21
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.87
|
| Rate for Payer: Prime Health Services Commercial |
$65.66
|
| Rate for Payer: Prime Health Services Medicare |
$13.64
|
| Rate for Payer: Riverside University Health System MISP |
$14.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$46.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$46.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.42
|
| Rate for Payer: United Healthcare All Other HMO |
$10.42
|
| Rate for Payer: United Healthcare HMO Rider |
$10.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC SOM HBEL ELECTROPHORESIS SUMMARY INTERP
|
Facility
|
IP
|
$77.25
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
900915460
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$15.45 |
| Max. Negotiated Rate |
$69.53 |
| Rate for Payer: Adventist Health Commercial |
$15.45
|
| Rate for Payer: Cash Price |
$77.25
|
| Rate for Payer: Central Health Plan Commercial |
$61.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$54.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.90
|
| Rate for Payer: EPIC Health Plan Senior |
$30.90
|
| Rate for Payer: Galaxy Health WC |
$65.66
|
| Rate for Payer: Global Benefits Group Commercial |
$46.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$69.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$49.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$45.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.45
|
| Rate for Payer: Multiplan Commercial |
$57.94
|
| Rate for Payer: Networks By Design Commercial |
$50.21
|
| Rate for Payer: Prime Health Services Commercial |
$65.66
|
|
|
HC SOM HBEL VARIANT, A2 AND F QUANTITATION,B
|
Facility
|
OP
|
$12.56
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
900915458
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.51 |
| Max. Negotiated Rate |
$110.58 |
| Rate for Payer: Adventist Health Commercial |
$2.51
|
| Rate for Payer: Adventist Health Medi-Cal |
$12.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$94.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$79.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.58
|
| Rate for Payer: Blue Shield of California Commercial |
$7.91
|
| Rate for Payer: Blue Shield of California EPN |
$4.99
|
| Rate for Payer: Cash Price |
$12.56
|
| Rate for Payer: Cash Price |
$12.56
|
| Rate for Payer: Central Health Plan Commercial |
$10.05
|
| Rate for Payer: Cigna of CA HMO |
$8.04
|
| Rate for Payer: Cigna of CA PPO |
$9.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.24
|
| Rate for Payer: EPIC Health Plan Senior |
$14.16
|
| Rate for Payer: Galaxy Health WC |
$10.68
|
| Rate for Payer: Global Benefits Group Commercial |
$7.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$21.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$12.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.25
|
| Rate for Payer: Multiplan Commercial |
$9.42
|
| Rate for Payer: Networks By Design Commercial |
$8.16
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$12.87
|
| Rate for Payer: Prime Health Services Commercial |
$10.68
|
| Rate for Payer: Prime Health Services Medicare |
$13.64
|
| Rate for Payer: Riverside University Health System MISP |
$14.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.42
|
| Rate for Payer: United Healthcare All Other HMO |
$10.42
|
| Rate for Payer: United Healthcare HMO Rider |
$10.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$12.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC SOM HBEL VARIANT, A2 AND F QUANTITATION,B
|
Facility
|
IP
|
$12.56
|
|
|
Service Code
|
CPT 83020
|
| Hospital Charge Code |
900915458
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$2.51 |
| Max. Negotiated Rate |
$11.30 |
| Rate for Payer: Adventist Health Commercial |
$2.51
|
| Rate for Payer: Cash Price |
$12.56
|
| Rate for Payer: Central Health Plan Commercial |
$10.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.02
|
| Rate for Payer: EPIC Health Plan Senior |
$5.02
|
| Rate for Payer: Galaxy Health WC |
$10.68
|
| Rate for Payer: Global Benefits Group Commercial |
$7.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.51
|
| Rate for Payer: Multiplan Commercial |
$9.42
|
| Rate for Payer: Networks By Design Commercial |
$8.16
|
| Rate for Payer: Prime Health Services Commercial |
$10.68
|
|
|
HC SOM HBEL VARIANT B
|
Facility
|
OP
|
$17.62
|
|
|
Service Code
|
CPT 83021
|
| Hospital Charge Code |
900915459
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.52 |
| Max. Negotiated Rate |
$181.87 |
| Rate for Payer: Adventist Health Commercial |
$3.52
|
| Rate for Payer: Adventist Health Medi-Cal |
$18.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$130.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$181.87
|
| Rate for Payer: Blue Shield of California Commercial |
$11.10
|
| Rate for Payer: Blue Shield of California EPN |
$7.00
|
| Rate for Payer: Cash Price |
$17.62
|
| Rate for Payer: Cash Price |
$17.62
|
| Rate for Payer: Central Health Plan Commercial |
$14.10
|
| Rate for Payer: Cigna of CA HMO |
$11.28
|
| Rate for Payer: Cigna of CA PPO |
$13.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.80
|
| Rate for Payer: EPIC Health Plan Senior |
$19.87
|
| Rate for Payer: Galaxy Health WC |
$14.98
|
| Rate for Payer: Global Benefits Group Commercial |
$10.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.86
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$29.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$26.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.20
|
| Rate for Payer: Multiplan Commercial |
$13.21
|
| Rate for Payer: Networks By Design Commercial |
$11.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18.06
|
| Rate for Payer: Prime Health Services Commercial |
$14.98
|
| Rate for Payer: Prime Health Services Medicare |
$19.14
|
| Rate for Payer: Riverside University Health System MISP |
$19.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.62
|
| Rate for Payer: United Healthcare All Other HMO |
$14.62
|
| Rate for Payer: United Healthcare HMO Rider |
$14.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.62
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.87
|
| Rate for Payer: Vantage Medical Group Senior |
$18.06
|
|
|
HC SOM HBEL VARIANT B
|
Facility
|
IP
|
$17.62
|
|
|
Service Code
|
CPT 83021
|
| Hospital Charge Code |
900915459
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$3.52 |
| Max. Negotiated Rate |
$15.86 |
| Rate for Payer: Adventist Health Commercial |
$3.52
|
| Rate for Payer: Cash Price |
$17.62
|
| Rate for Payer: Central Health Plan Commercial |
$14.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Senior |
$7.05
|
| Rate for Payer: Galaxy Health WC |
$14.98
|
| Rate for Payer: Global Benefits Group Commercial |
$10.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.52
|
| Rate for Payer: Multiplan Commercial |
$13.21
|
| Rate for Payer: Networks By Design Commercial |
$11.45
|
| Rate for Payer: Prime Health Services Commercial |
$14.98
|
|
|
HC SOM HCG HIGH SENSITIVITY
|
Facility
|
OP
|
$16.77
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
900914546
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$145.71 |
| Rate for Payer: Adventist Health Commercial |
$3.35
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$104.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$145.71
|
| Rate for Payer: Blue Shield of California Commercial |
$10.57
|
| Rate for Payer: Blue Shield of California EPN |
$6.66
|
| Rate for Payer: Cash Price |
$16.77
|
| Rate for Payer: Cash Price |
$16.77
|
| Rate for Payer: Central Health Plan Commercial |
$13.42
|
| Rate for Payer: Cigna of CA HMO |
$10.73
|
| Rate for Payer: Cigna of CA PPO |
$12.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.83
|
| Rate for Payer: EPIC Health Plan Senior |
$16.55
|
| Rate for Payer: Galaxy Health WC |
$14.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.09
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$24.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.17
|
| Rate for Payer: Multiplan Commercial |
$12.58
|
| Rate for Payer: Networks By Design Commercial |
$10.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.05
|
| Rate for Payer: Prime Health Services Commercial |
$14.25
|
| Rate for Payer: Prime Health Services Medicare |
$15.95
|
| Rate for Payer: Riverside University Health System MISP |
$16.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.20
|
| Rate for Payer: United Healthcare All Other HMO |
$12.20
|
| Rate for Payer: United Healthcare HMO Rider |
$12.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.20
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
HC SOM HCG HIGH SENSITIVITY
|
Facility
|
IP
|
$16.77
|
|
|
Service Code
|
CPT 84702
|
| Hospital Charge Code |
900914546
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$15.09 |
| Rate for Payer: Adventist Health Commercial |
$3.35
|
| Rate for Payer: Cash Price |
$16.77
|
| Rate for Payer: Central Health Plan Commercial |
$13.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.71
|
| Rate for Payer: EPIC Health Plan Senior |
$6.71
|
| Rate for Payer: Galaxy Health WC |
$14.25
|
| Rate for Payer: Global Benefits Group Commercial |
$10.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.35
|
| Rate for Payer: Multiplan Commercial |
$12.58
|
| Rate for Payer: Networks By Design Commercial |
$10.90
|
| Rate for Payer: Prime Health Services Commercial |
$14.25
|
|
|
HC SOM HCV GENOTYPING
|
Facility
|
IP
|
$140.69
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
900911374
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.14 |
| Max. Negotiated Rate |
$126.62 |
| Rate for Payer: Adventist Health Commercial |
$28.14
|
| Rate for Payer: Cash Price |
$140.69
|
| Rate for Payer: Central Health Plan Commercial |
$112.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$98.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.28
|
| Rate for Payer: EPIC Health Plan Senior |
$56.28
|
| Rate for Payer: Galaxy Health WC |
$119.59
|
| Rate for Payer: Global Benefits Group Commercial |
$84.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$89.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$83.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.14
|
| Rate for Payer: Multiplan Commercial |
$105.52
|
| Rate for Payer: Networks By Design Commercial |
$91.45
|
| Rate for Payer: Prime Health Services Commercial |
$119.59
|
|
|
HC SOM HCV GENOTYPING
|
Facility
|
OP
|
$140.69
|
|
|
Service Code
|
CPT 87902
|
| Hospital Charge Code |
900911374
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$28.14 |
| Max. Negotiated Rate |
$2,602.06 |
| Rate for Payer: Adventist Health Commercial |
$28.14
|
| Rate for Payer: Adventist Health Medi-Cal |
$257.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,889.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$386.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$257.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,871.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,602.06
|
| Rate for Payer: Blue Shield of California Commercial |
$88.63
|
| Rate for Payer: Blue Shield of California EPN |
$55.85
|
| Rate for Payer: Cash Price |
$140.69
|
| Rate for Payer: Cash Price |
$140.69
|
| Rate for Payer: Central Health Plan Commercial |
$112.55
|
| Rate for Payer: Cigna of CA HMO |
$90.04
|
| Rate for Payer: Cigna of CA PPO |
$104.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$386.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$257.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$98.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$424.79
|
| Rate for Payer: EPIC Health Plan Senior |
$283.19
|
| Rate for Payer: Galaxy Health WC |
$119.59
|
| Rate for Payer: Global Benefits Group Commercial |
$84.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.62
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$422.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$393.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$257.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$89.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$434.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$360.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$344.98
|
| Rate for Payer: Multiplan Commercial |
$105.52
|
| Rate for Payer: Networks By Design Commercial |
$91.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$257.45
|
| Rate for Payer: Prime Health Services Commercial |
$119.59
|
| Rate for Payer: Prime Health Services Medicare |
$272.90
|
| Rate for Payer: Riverside University Health System MISP |
$283.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$84.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$84.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$208.54
|
| Rate for Payer: United Healthcare All Other HMO |
$208.54
|
| Rate for Payer: United Healthcare HMO Rider |
$208.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$208.54
|
| Rate for Payer: Upland Medical Group Pediatric |
$257.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$386.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.19
|
| Rate for Payer: Vantage Medical Group Senior |
$257.45
|
|
|
HC SOM HEMO A INV INTERP
|
Facility
|
IP
|
$553.05
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
900914242
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$110.61 |
| Max. Negotiated Rate |
$497.75 |
| Rate for Payer: Adventist Health Commercial |
$110.61
|
| Rate for Payer: Cash Price |
$553.05
|
| Rate for Payer: Central Health Plan Commercial |
$442.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$387.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$221.22
|
| Rate for Payer: EPIC Health Plan Senior |
$221.22
|
| Rate for Payer: Galaxy Health WC |
$470.09
|
| Rate for Payer: Global Benefits Group Commercial |
$331.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$497.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$351.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$326.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.61
|
| Rate for Payer: Multiplan Commercial |
$414.79
|
| Rate for Payer: Networks By Design Commercial |
$359.48
|
| Rate for Payer: Prime Health Services Commercial |
$470.09
|
|
|
HC SOM HEMO A INV INTERP
|
Facility
|
OP
|
$553.05
|
|
|
Service Code
|
CPT 81403
|
| Hospital Charge Code |
900914242
|
|
Hospital Revenue Code
|
309
|
| Min. Negotiated Rate |
$110.61 |
| Max. Negotiated Rate |
$1,513.57 |
| Rate for Payer: Adventist Health Commercial |
$110.61
|
| Rate for Payer: Adventist Health Medi-Cal |
$185.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$368.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$277.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$203.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$185.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,088.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,513.57
|
| Rate for Payer: Blue Shield of California Commercial |
$348.42
|
| Rate for Payer: Blue Shield of California EPN |
$219.56
|
| Rate for Payer: Cash Price |
$553.05
|
| Rate for Payer: Cash Price |
$553.05
|
| Rate for Payer: Central Health Plan Commercial |
$442.44
|
| Rate for Payer: Cigna of CA HMO |
$353.95
|
| Rate for Payer: Cigna of CA PPO |
$409.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$203.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$185.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$387.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$305.58
|
| Rate for Payer: EPIC Health Plan Senior |
$203.72
|
| Rate for Payer: Galaxy Health WC |
$470.09
|
| Rate for Payer: Global Benefits Group Commercial |
$331.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$497.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$303.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$318.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$185.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$351.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$351.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$259.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$248.17
|
| Rate for Payer: Multiplan Commercial |
$414.79
|
| Rate for Payer: Networks By Design Commercial |
$359.48
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$185.20
|
| Rate for Payer: Prime Health Services Commercial |
$470.09
|
| Rate for Payer: Prime Health Services Medicare |
$196.31
|
| Rate for Payer: Riverside University Health System MISP |
$203.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$331.83
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$331.83
|
| Rate for Payer: United Healthcare All Other Commercial |
$150.01
|
| Rate for Payer: United Healthcare All Other HMO |
$150.01
|
| Rate for Payer: United Healthcare HMO Rider |
$150.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$150.01
|
| Rate for Payer: Upland Medical Group Pediatric |
$185.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$277.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$203.72
|
| Rate for Payer: Vantage Medical Group Senior |
$185.20
|
|
|
HC SOM HEMOCHROMATOSIS GENE PCR
|
Facility
|
OP
|
$178.63
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
900910606
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.73 |
| Max. Negotiated Rate |
$544.72 |
| Rate for Payer: Adventist Health Commercial |
$35.73
|
| Rate for Payer: Adventist Health Medi-Cal |
$65.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$244.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$98.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$71.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$65.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$391.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$544.72
|
| Rate for Payer: Blue Shield of California Commercial |
$112.54
|
| Rate for Payer: Blue Shield of California EPN |
$70.92
|
| Rate for Payer: Cash Price |
$178.63
|
| Rate for Payer: Cash Price |
$178.63
|
| Rate for Payer: Central Health Plan Commercial |
$142.90
|
| Rate for Payer: Cigna of CA HMO |
$114.32
|
| Rate for Payer: Cigna of CA PPO |
$132.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$71.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$65.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.84
|
| Rate for Payer: EPIC Health Plan Senior |
$71.90
|
| Rate for Payer: Galaxy Health WC |
$151.84
|
| Rate for Payer: Global Benefits Group Commercial |
$107.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$160.77
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$107.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$96.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$65.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$106.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$91.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.73
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$87.58
|
| Rate for Payer: Multiplan Commercial |
$133.97
|
| Rate for Payer: Networks By Design Commercial |
$116.11
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$65.36
|
| Rate for Payer: Prime Health Services Commercial |
$151.84
|
| Rate for Payer: Prime Health Services Medicare |
$69.28
|
| Rate for Payer: Riverside University Health System MISP |
$71.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.94
|
| Rate for Payer: United Healthcare All Other HMO |
$52.94
|
| Rate for Payer: United Healthcare HMO Rider |
$52.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$52.94
|
| Rate for Payer: Upland Medical Group Pediatric |
$65.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$98.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$71.90
|
| Rate for Payer: Vantage Medical Group Senior |
$65.36
|
|
|
HC SOM HEMOCHROMATOSIS GENE PCR
|
Facility
|
IP
|
$178.63
|
|
|
Service Code
|
CPT 81256
|
| Hospital Charge Code |
900910606
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$35.73 |
| Max. Negotiated Rate |
$160.77 |
| Rate for Payer: Adventist Health Commercial |
$35.73
|
| Rate for Payer: Cash Price |
$178.63
|
| Rate for Payer: Central Health Plan Commercial |
$142.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.45
|
| Rate for Payer: EPIC Health Plan Senior |
$71.45
|
| Rate for Payer: Galaxy Health WC |
$151.84
|
| Rate for Payer: Global Benefits Group Commercial |
$107.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$160.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$105.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.73
|
| Rate for Payer: Multiplan Commercial |
$133.97
|
| Rate for Payer: Networks By Design Commercial |
$116.11
|
| Rate for Payer: Prime Health Services Commercial |
$151.84
|
|
|
HC SOM HEMOSIDERIN, URINE
|
Facility
|
OP
|
$33.00
|
|
|
Service Code
|
CPT 83070
|
| Hospital Charge Code |
900910748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.85 |
| Max. Negotiated Rate |
$48.00 |
| Rate for Payer: Adventist Health Commercial |
$6.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.85
|
| 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 Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.00
|
| Rate for Payer: Blue Shield of California Commercial |
$20.79
|
| Rate for Payer: Blue Shield of California EPN |
$13.10
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Central Health Plan Commercial |
$26.40
|
| Rate for Payer: Cigna of CA HMO |
$21.12
|
| Rate for Payer: Cigna of CA PPO |
$24.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.84
|
| Rate for Payer: EPIC Health Plan Senior |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$28.05
|
| Rate for Payer: Global Benefits Group Commercial |
$19.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.75
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.37
|
| Rate for Payer: Multiplan Commercial |
$24.75
|
| Rate for Payer: Networks By Design Commercial |
$21.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.75
|
| Rate for Payer: Prime Health Services Commercial |
$28.05
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Riverside University Health System MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.80
|
| 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 HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| 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 Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC SOM HEMOSIDERIN, URINE
|
Facility
|
IP
|
$33.00
|
|
|
Service Code
|
CPT 83070
|
| Hospital Charge Code |
900910748
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$6.60 |
| Max. Negotiated Rate |
$29.70 |
| Rate for Payer: Adventist Health Commercial |
$6.60
|
| Rate for Payer: Cash Price |
$33.00
|
| Rate for Payer: Central Health Plan Commercial |
$26.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.20
|
| Rate for Payer: EPIC Health Plan Senior |
$13.20
|
| Rate for Payer: Galaxy Health WC |
$28.05
|
| Rate for Payer: Global Benefits Group Commercial |
$19.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.60
|
| Rate for Payer: Multiplan Commercial |
$24.75
|
| Rate for Payer: Networks By Design Commercial |
$21.45
|
| Rate for Payer: Prime Health Services Commercial |
$28.05
|
|
|
HC SOM HEPARIN-PF4 AB
|
Facility
|
OP
|
$43.68
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
900912527
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$157.63 |
| Rate for Payer: Adventist Health Commercial |
$8.74
|
| Rate for Payer: Adventist Health Medi-Cal |
$18.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$134.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$113.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$157.63
|
| Rate for Payer: Blue Shield of California Commercial |
$27.52
|
| Rate for Payer: Blue Shield of California EPN |
$17.34
|
| Rate for Payer: Cash Price |
$43.68
|
| Rate for Payer: Cash Price |
$43.68
|
| Rate for Payer: Central Health Plan Commercial |
$34.94
|
| Rate for Payer: Cigna of CA HMO |
$27.96
|
| Rate for Payer: Cigna of CA PPO |
$32.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.31
|
| Rate for Payer: EPIC Health Plan Senior |
$20.21
|
| Rate for Payer: Galaxy Health WC |
$37.13
|
| Rate for Payer: Global Benefits Group Commercial |
$26.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$30.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$18.37
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.62
|
| Rate for Payer: Multiplan Commercial |
$32.76
|
| Rate for Payer: Networks By Design Commercial |
$28.39
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$18.37
|
| Rate for Payer: Prime Health Services Commercial |
$37.13
|
| Rate for Payer: Prime Health Services Medicare |
$19.47
|
| Rate for Payer: Riverside University Health System MISP |
$20.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.88
|
| Rate for Payer: United Healthcare All Other HMO |
$14.88
|
| Rate for Payer: United Healthcare HMO Rider |
$14.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.88
|
| Rate for Payer: Upland Medical Group Pediatric |
$18.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.21
|
| Rate for Payer: Vantage Medical Group Senior |
$18.37
|
|
|
HC SOM HEPARIN-PF4 AB
|
Facility
|
IP
|
$43.68
|
|
|
Service Code
|
CPT 86022
|
| Hospital Charge Code |
900912527
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$39.31 |
| Rate for Payer: Adventist Health Commercial |
$8.74
|
| Rate for Payer: Cash Price |
$43.68
|
| Rate for Payer: Central Health Plan Commercial |
$34.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.47
|
| Rate for Payer: EPIC Health Plan Senior |
$17.47
|
| Rate for Payer: Galaxy Health WC |
$37.13
|
| Rate for Payer: Global Benefits Group Commercial |
$26.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$39.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$32.76
|
| Rate for Payer: Networks By Design Commercial |
$28.39
|
| Rate for Payer: Prime Health Services Commercial |
$37.13
|
|
