|
HC ALELRGEN GRAPEFRUIT IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913587
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
|
HC ALELRGEN GRAPEFRUIT IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913587
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$144.32 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.32
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Heritage Provider Network Senior |
$40.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALKALINE PHOSPHATASE
|
Facility
|
OP
|
$94.00
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
900910219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$70.50 |
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$50.24
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$64.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.20
|
| Rate for Payer: Blue Shield of California Commercial |
$41.64
|
| Rate for Payer: Blue Shield of California EPN |
$33.40
|
| Rate for Payer: Cash Price |
$51.70
|
| Rate for Payer: Cash Price |
$51.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$61.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$58.19
|
| Rate for Payer: Heritage Provider Network Senior |
$58.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$44.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.01
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.53
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.18
|
| Rate for Payer: TriValley Medical Group Senior |
$5.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC ALKALINE PHOSPHATASE
|
Facility
|
IP
|
$94.00
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
900910219
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.01 |
| Max. Negotiated Rate |
$70.50 |
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Cash Price |
$51.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$63.64
|
| Rate for Payer: Heritage Provider Network Senior |
$63.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.50
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
|
|
HC ALKALINE PHOSPHATASE INDIV
|
Facility
|
OP
|
$98.00
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
900910508
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$52.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.20
|
| Rate for Payer: Blue Shield of California Commercial |
$41.64
|
| Rate for Payer: Blue Shield of California EPN |
$33.40
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$63.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.70
|
| Rate for Payer: Dignity Health Senior |
$5.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.66
|
| Rate for Payer: Heritage Provider Network Senior |
$60.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$46.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.53
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.18
|
| Rate for Payer: TriValley Medical Group Senior |
$5.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.70
|
| Rate for Payer: Vantage Medical Group Senior |
$5.18
|
|
|
HC ALKALINE PHOSPHATASE INDIV
|
Facility
|
IP
|
$98.00
|
|
|
Service Code
|
CPT 84075
|
| Hospital Charge Code |
900910508
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.74 |
| Max. Negotiated Rate |
$73.50 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Heritage Provider Network Commercial |
$66.35
|
| Rate for Payer: Heritage Provider Network Senior |
$66.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.50
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
|
|
HC ALLELRGEN GREEN PEPPER IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913601
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$144.32 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.32
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Heritage Provider Network Senior |
$40.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLELRGEN GREEN PEPPER IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913601
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
|
HC ALLERGEN A ALTERNATA IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
|
HC ALLERGEN A ALTERNATA IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912344
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$144.32 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.32
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Heritage Provider Network Senior |
$40.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLERGEN ALDER E IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
|
HC ALLERGEN ALDER E IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912345
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$144.32 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.32
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Heritage Provider Network Senior |
$40.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLERGEN ALMOND IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
|
HC ALLERGEN ALMOND IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912346
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$144.32 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.32
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Heritage Provider Network Senior |
$40.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLERGEN ALPHA-LACTOALBUMIN IGE
|
Facility
|
IP
|
$26.00
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913570
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.71 |
| Max. Negotiated Rate |
$19.50 |
| Rate for Payer: Adventist Health Commercial |
$5.20
|
| Rate for Payer: Cash Price |
$14.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.60
|
| Rate for Payer: Heritage Provider Network Senior |
$17.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.50
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
|
|
HC ALLERGEN ALPHA-LACTOALBUMIN IGE
|
Facility
|
OP
|
$26.00
|
|
|
Service Code
|
CPT 86008
|
| Hospital Charge Code |
900913570
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.71 |
| Max. Negotiated Rate |
$151.01 |
| Rate for Payer: Adventist Health Commercial |
$5.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$13.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$17.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$151.01
|
| Rate for Payer: Blue Shield of California Commercial |
$127.53
|
| Rate for Payer: Blue Shield of California EPN |
$102.29
|
| Rate for Payer: Cash Price |
$14.30
|
| Rate for Payer: Cash Price |
$14.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$16.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.72
|
| Rate for Payer: Dignity Health Senior |
$17.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$17.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.09
|
| Rate for Payer: Heritage Provider Network Senior |
$16.09
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$25.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$17.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.59
|
| Rate for Payer: Multiplan Commercial |
$19.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.93
|
| Rate for Payer: TriValley Medical Group Senior |
$17.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.72
|
| Rate for Payer: Vantage Medical Group Senior |
$17.93
|
|
|
HC ALLERGEN APPLE IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912347
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$144.32 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.32
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Heritage Provider Network Senior |
$40.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLERGEN APPLE IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912347
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
|
HC ALLERGEN ASPERGILLUS FUM IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913547
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$144.32 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.32
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Heritage Provider Network Senior |
$40.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLERGEN ASPERGILLUS FUM IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913547
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
|
HC ALLERGEN AVOCADO IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
|
HC ALLERGEN AVOCADO IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912348
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$144.32 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.32
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Heritage Provider Network Senior |
$40.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLERGEN BAHIA GRASS IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
|
HC ALLERGEN BAHIA GRASS IGE
|
Facility
|
OP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912339
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$5.22 |
| Max. Negotiated Rate |
$144.32 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$35.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$45.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.32
|
| Rate for Payer: Blue Shield of California Commercial |
$42.05
|
| Rate for Payer: Blue Shield of California EPN |
$33.73
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Cigna of CA HMO/PPO |
$42.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.90
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$40.85
|
| Rate for Payer: Heritage Provider Network Senior |
$40.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$31.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC ALLERGEN BANANA IGE
|
Facility
|
IP
|
$66.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912349
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$11.95 |
| Max. Negotiated Rate |
$49.50 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.68
|
| Rate for Payer: Heritage Provider Network Senior |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.50
|
| Rate for Payer: Multiplan Commercial |
$49.50
|
|
