|
HC CULTURE CATHETER TIP
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912437
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$25.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.02
|
| Rate for Payer: Blue Shield of California Commercial |
$67.25
|
| Rate for Payer: Blue Shield of California EPN |
$52.57
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.81
|
| Rate for Payer: Heritage Provider Network Senior |
$19.81
|
| Rate for Payer: Humana Medicare |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE CLO TEST
|
Facility
|
OP
|
$31.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900910670
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$67.56 |
| Rate for Payer: Adventist Health Commercial |
$6.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$23.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$67.56
|
| Rate for Payer: Blue Shield of California Commercial |
$63.11
|
| Rate for Payer: Blue Shield of California EPN |
$49.34
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cash Price |
$13.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Senior |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.19
|
| Rate for Payer: Heritage Provider Network Senior |
$19.19
|
| Rate for Payer: Humana Medicare |
$8.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.18
|
| Rate for Payer: Multiplan Commercial |
$23.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.08
|
| Rate for Payer: TriValley Medical Group Senior |
$8.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC CULTURE CLO TEST
|
Facility
|
IP
|
$136.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900910670
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$24.62 |
| Max. Negotiated Rate |
$102.00 |
| Rate for Payer: Adventist Health Commercial |
$27.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$93.43
|
| Rate for Payer: Cash Price |
$61.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$92.07
|
| Rate for Payer: Heritage Provider Network Senior |
$92.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Multiplan Commercial |
$102.00
|
|
|
HC CULTURE CRYPTOCOCCUS SCREEN
|
Facility
|
IP
|
$115.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900911610
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$20.82 |
| Max. Negotiated Rate |
$86.25 |
| Rate for Payer: Adventist Health Commercial |
$23.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$79.00
|
| Rate for Payer: Cash Price |
$51.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$77.86
|
| Rate for Payer: Heritage Provider Network Senior |
$77.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.75
|
| Rate for Payer: Multiplan Commercial |
$86.25
|
|
|
HC CULTURE CRYPTOCOCCUS SCREEN
|
Facility
|
OP
|
$20.00
|
|
|
Service Code
|
CPT 87147
|
| Hospital Charge Code |
900911610
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$40.42 |
| Rate for Payer: Adventist Health Commercial |
$4.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.28
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.74
|
| 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 |
$39.16
|
| Rate for Payer: Blue Shield of California Commercial |
$40.42
|
| Rate for Payer: Blue Shield of California EPN |
$31.60
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cash Price |
$9.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.00
|
| 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 |
$13.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.38
|
| Rate for Payer: Heritage Provider Network Senior |
$12.38
|
| Rate for Payer: Humana Medicare |
$5.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.00
|
| 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 |
$15.00
|
| 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 CULTURE CSF
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911505
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.22 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Adventist Health Commercial |
$79.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$274.11
|
| Rate for Payer: Cash Price |
$179.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$270.12
|
| Rate for Payer: Heritage Provider Network Senior |
$270.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.75
|
| Rate for Payer: Multiplan Commercial |
$299.25
|
|
|
HC CULTURE CSF
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911505
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$25.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.02
|
| Rate for Payer: Blue Shield of California Commercial |
$67.25
|
| Rate for Payer: Blue Shield of California EPN |
$52.57
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.81
|
| Rate for Payer: Heritage Provider Network Senior |
$19.81
|
| Rate for Payer: Humana Medicare |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE CYSTIC FIBROSIS
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911533
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.22 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Adventist Health Commercial |
$79.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$274.11
|
| Rate for Payer: Cash Price |
$179.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$270.12
|
| Rate for Payer: Heritage Provider Network Senior |
$270.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.75
|
| Rate for Payer: Multiplan Commercial |
$299.25
|
|
|
HC CULTURE CYSTIC FIBROSIS
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911533
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$25.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.02
|
| Rate for Payer: Blue Shield of California Commercial |
$67.25
|
| Rate for Payer: Blue Shield of California EPN |
$52.57
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.81
|
| Rate for Payer: Heritage Provider Network Senior |
$19.81
|
| Rate for Payer: Humana Medicare |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE ENVIORNMENTAL
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911532
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$25.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.02
|
| Rate for Payer: Blue Shield of California Commercial |
$67.25
|
| Rate for Payer: Blue Shield of California EPN |
$52.57
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.81
|
| Rate for Payer: Heritage Provider Network Senior |
$19.81
|
| Rate for Payer: Humana Medicare |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE ENVIORNMENTAL
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911532
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.22 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Adventist Health Commercial |
$79.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$274.11
|
| Rate for Payer: Cash Price |
$179.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$270.12
|
| Rate for Payer: Heritage Provider Network Senior |
$270.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.75
|
| Rate for Payer: Multiplan Commercial |
$299.25
|
|
|
HC CULTURE ENVIRONMENTAL
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912439
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$25.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.02
|
| Rate for Payer: Blue Shield of California Commercial |
$67.25
|
| Rate for Payer: Blue Shield of California EPN |
$52.57
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.81
|
| Rate for Payer: Heritage Provider Network Senior |
$19.81
|
| Rate for Payer: Humana Medicare |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE ENVIRONMENTAL
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912439
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.22 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Adventist Health Commercial |
$79.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$274.11
|
| Rate for Payer: Cash Price |
$179.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$270.12
|
| Rate for Payer: Heritage Provider Network Senior |
$270.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.75
|
| Rate for Payer: Multiplan Commercial |
$299.25
|
|
|
HC CULTURE FOR TB
|
Facility
|
OP
|
$41.00
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
900911526
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.42 |
| Max. Negotiated Rate |
$90.27 |
| Rate for Payer: Adventist Health Commercial |
$8.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.27
|
| Rate for Payer: Blue Shield of California Commercial |
$84.41
|
| Rate for Payer: Blue Shield of California EPN |
$65.99
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cash Price |
$18.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.88
|
| Rate for Payer: Dignity Health Senior |
$10.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.65
|
| Rate for Payer: EPIC Health Plan Medicare |
$10.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$25.38
|
| Rate for Payer: Heritage Provider Network Senior |
$25.38
|
| Rate for Payer: Humana Medicare |
$10.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$14.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.61
|
| Rate for Payer: Multiplan Commercial |
$30.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$10.80
|
| Rate for Payer: TriValley Medical Group Senior |
$10.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$11.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Vantage Medical Group Senior |
$10.80
|
|
|
HC CULTURE FOR TB
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 87116
|
| Hospital Charge Code |
900911526
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.22 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Adventist Health Commercial |
$79.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$274.11
|
| Rate for Payer: Cash Price |
$179.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$270.12
|
| Rate for Payer: Heritage Provider Network Senior |
$270.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.75
|
| Rate for Payer: Multiplan Commercial |
$299.25
|
|
|
HC CULTURE FOR VIROLOGY
|
Facility
|
OP
|
$78.00
|
|
|
Service Code
|
CPT 87252
|
| Hospital Charge Code |
900911528
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$14.12 |
| Max. Negotiated Rate |
$218.19 |
| Rate for Payer: Adventist Health Commercial |
$15.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$75.84
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$53.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$218.19
|
| Rate for Payer: Blue Shield of California Commercial |
$203.59
|
| Rate for Payer: Blue Shield of California EPN |
$159.16
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cash Price |
$35.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$50.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.68
|
| Rate for Payer: Dignity Health Senior |
$26.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.70
|
| Rate for Payer: EPIC Health Plan Medicare |
$26.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$48.28
|
| Rate for Payer: Heritage Provider Network Senior |
$48.28
|
| Rate for Payer: Humana Medicare |
$26.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$33.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$49.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.85
|
| Rate for Payer: Multiplan Commercial |
$58.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$26.07
|
| Rate for Payer: TriValley Medical Group Senior |
$26.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$28.15
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$28.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.68
|
| Rate for Payer: Vantage Medical Group Senior |
$26.07
|
|
|
HC CULTURE FOR VIROLOGY
|
Facility
|
IP
|
$599.00
|
|
|
Service Code
|
CPT 87252
|
| Hospital Charge Code |
900911528
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$108.42 |
| Max. Negotiated Rate |
$449.25 |
| Rate for Payer: Adventist Health Commercial |
$119.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$411.51
|
| Rate for Payer: Cash Price |
$269.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$405.52
|
| Rate for Payer: Heritage Provider Network Senior |
$405.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$108.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$149.75
|
| Rate for Payer: Multiplan Commercial |
$449.25
|
|
|
HC CULTURE FUNGUS (BLOOD)
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 87103
|
| Hospital Charge Code |
900912430
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.41 |
| Max. Negotiated Rate |
$75.45 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.24
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$35.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.45
|
| Rate for Payer: Blue Shield of California Commercial |
$70.43
|
| Rate for Payer: Blue Shield of California EPN |
$55.06
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$33.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.51
|
| Rate for Payer: Dignity Health Senior |
$20.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.19
|
| Rate for Payer: Heritage Provider Network Senior |
$32.19
|
| Rate for Payer: Humana Medicare |
$20.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$38.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$24.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.78
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.46
|
| Rate for Payer: TriValley Medical Group Senior |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$22.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$22.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Vantage Medical Group Senior |
$20.46
|
|
|
HC CULTURE FUNGUS (BLOOD)
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
CPT 87103
|
| Hospital Charge Code |
900912430
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$48.87 |
| Max. Negotiated Rate |
$202.50 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$185.49
|
| Rate for Payer: Cash Price |
$121.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$182.79
|
| Rate for Payer: Heritage Provider Network Senior |
$182.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.50
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
|
|
HC CULTURE FUNGUS OTHER
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
900911523
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$70.33 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$24.47
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.33
|
| Rate for Payer: Blue Shield of California Commercial |
$65.63
|
| Rate for Payer: Blue Shield of California EPN |
$51.30
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.25
|
| Rate for Payer: Dignity Health Senior |
$8.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.81
|
| Rate for Payer: Heritage Provider Network Senior |
$19.81
|
| Rate for Payer: Humana Medicare |
$8.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$15.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.60
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.41
|
| Rate for Payer: TriValley Medical Group Senior |
$8.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Vantage Medical Group Senior |
$8.41
|
|
|
HC CULTURE FUNGUS OTHER
|
Facility
|
IP
|
$361.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
900911523
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$65.34 |
| Max. Negotiated Rate |
$270.75 |
| Rate for Payer: Adventist Health Commercial |
$72.20
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$248.01
|
| Rate for Payer: Cash Price |
$162.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$244.40
|
| Rate for Payer: Heritage Provider Network Senior |
$244.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.25
|
| Rate for Payer: Multiplan Commercial |
$270.75
|
|
|
HC CULTURE FUNGUS(SKIN,HAIR,NAIL)
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
900912429
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.22 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Adventist Health Commercial |
$79.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$274.11
|
| Rate for Payer: Cash Price |
$179.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$270.12
|
| Rate for Payer: Heritage Provider Network Senior |
$270.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.75
|
| Rate for Payer: Multiplan Commercial |
$299.25
|
|
|
HC CULTURE FUNGUS(SKIN,HAIR,NAIL)
|
Facility
|
OP
|
$52.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
900912429
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$64.52 |
| Rate for Payer: Adventist Health Commercial |
$10.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$22.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$35.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.52
|
| Rate for Payer: Blue Shield of California Commercial |
$60.20
|
| Rate for Payer: Blue Shield of California EPN |
$47.06
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$33.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.48
|
| Rate for Payer: Dignity Health Senior |
$7.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.19
|
| Rate for Payer: Heritage Provider Network Senior |
$32.19
|
| Rate for Payer: Humana Medicare |
$7.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.71
|
| Rate for Payer: Multiplan Commercial |
$39.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.71
|
| Rate for Payer: TriValley Medical Group Senior |
$7.71
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7.71
|
|
|
HC CULTURE GASTRIC ASPIRATE
|
Facility
|
IP
|
$399.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911506
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$72.22 |
| Max. Negotiated Rate |
$299.25 |
| Rate for Payer: Adventist Health Commercial |
$79.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$274.11
|
| Rate for Payer: Cash Price |
$179.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$270.12
|
| Rate for Payer: Heritage Provider Network Senior |
$270.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$72.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$99.75
|
| Rate for Payer: Multiplan Commercial |
$299.25
|
|
|
HC CULTURE GASTRIC ASPIRATE
|
Facility
|
OP
|
$32.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911506
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$5.79 |
| Max. Negotiated Rate |
$72.02 |
| Rate for Payer: Adventist Health Commercial |
$6.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$25.05
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$21.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.02
|
| Rate for Payer: Blue Shield of California Commercial |
$67.25
|
| Rate for Payer: Blue Shield of California EPN |
$52.57
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cash Price |
$14.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$20.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Senior |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.81
|
| Rate for Payer: Heritage Provider Network Senior |
$19.81
|
| Rate for Payer: Humana Medicare |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$11.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$16.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.86
|
| Rate for Payer: Multiplan Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$8.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
