|
HC CULTURE FUNGUS (BLOOD)
|
Facility
|
IP
|
$264.00
|
|
|
Service Code
|
CPT 87103
|
| Hospital Charge Code |
900912430
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$47.78 |
| Max. Negotiated Rate |
$198.00 |
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$170.02
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$178.73
|
| Rate for Payer: Heritage Provider Network Senior |
$178.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$47.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
|
|
HC CULTURE FUNGUS (BLOOD)
|
Facility
|
OP
|
$53.00
|
|
|
Service Code
|
CPT 87103
|
| Hospital Charge Code |
900912430
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.59 |
| Max. Negotiated Rate |
$85.59 |
| Rate for Payer: Adventist Health Commercial |
$10.60
|
| Rate for Payer: Adventist Health Commercial |
$52.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$163.15
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.69
|
| 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 Medi-Cal |
$22.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.59
|
| Rate for Payer: Blue Shield of California Commercial |
$72.58
|
| Rate for Payer: Blue Shield of California Commercial |
$72.58
|
| Rate for Payer: Blue Shield of California EPN |
$58.21
|
| Rate for Payer: Blue Shield of California EPN |
$58.21
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cash Price |
$23.85
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cash Price |
$118.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$171.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$34.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$155.76
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.46
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$163.42
|
| Rate for Payer: Heritage Provider Network Commercial |
$32.81
|
| Rate for Payer: Heritage Provider Network Senior |
$163.42
|
| Rate for Payer: Heritage Provider Network Senior |
$32.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$125.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$47.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.42
|
| Rate for Payer: Multiplan Commercial |
$198.00
|
| Rate for Payer: Multiplan Commercial |
$39.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.46
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.46
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$22.09
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$30.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: Vantage Medical Group Senior |
$20.46
|
| Rate for Payer: Vantage Medical Group Senior |
$20.46
|
|
|
HC CULTURE FUNGUS OTHER
|
Facility
|
IP
|
$353.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
900911523
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$63.89 |
| Max. Negotiated Rate |
$264.75 |
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$227.33
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$238.98
|
| Rate for Payer: Heritage Provider Network Senior |
$238.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.25
|
| Rate for Payer: Multiplan Commercial |
$264.75
|
|
|
HC CULTURE FUNGUS OTHER
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87102
|
| Hospital Charge Code |
900911523
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.41 |
| Max. Negotiated Rate |
$79.77 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Commercial |
$70.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$218.15
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.62
|
| 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 Medi-Cal |
$9.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.77
|
| Rate for Payer: Blue Shield of California Commercial |
$67.62
|
| Rate for Payer: Blue Shield of California Commercial |
$67.62
|
| Rate for Payer: Blue Shield of California EPN |
$54.24
|
| Rate for Payer: Blue Shield of California EPN |
$54.24
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Cash Price |
$158.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$229.45
|
| Rate for Payer: Cigna of CA HMO/PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$208.27
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.41
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$218.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.00
|
| Rate for Payer: Heritage Provider Network Senior |
$218.51
|
| Rate for Payer: Heritage Provider Network Senior |
$52.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$168.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$40.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$63.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$88.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.27
|
| Rate for Payer: Multiplan Commercial |
$264.75
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.41
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.41
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$9.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$12.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Vantage Medical Group Senior |
$8.41
|
| Rate for Payer: Vantage Medical Group Senior |
$8.41
|
|
|
HC CULTURE FUNGUS(SKIN,HAIR,NAIL)
|
Facility
|
IP
|
$395.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
900912429
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$71.50 |
| Max. Negotiated Rate |
$296.25 |
| Rate for Payer: Adventist Health Commercial |
$79.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$254.38
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: Heritage Provider Network Commercial |
$267.42
|
| Rate for Payer: Heritage Provider Network Senior |
$267.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$71.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.75
|
| Rate for Payer: Multiplan Commercial |
$296.25
|
|
|
HC CULTURE FUNGUS(SKIN,HAIR,NAIL)
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 87101
|
| Hospital Charge Code |
900912429
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$7.71 |
| Max. Negotiated Rate |
$73.19 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Adventist Health Commercial |
$79.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$244.11
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.56
|
| 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 Medi-Cal |
$8.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.19
|
| Rate for Payer: Blue Shield of California Commercial |
$62.04
|
| Rate for Payer: Blue Shield of California Commercial |
$62.04
|
| Rate for Payer: Blue Shield of California EPN |
$49.76
|
| Rate for Payer: Blue Shield of California EPN |
$49.76
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: Cash Price |
$177.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$256.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$53.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.71
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$244.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.76
|
| Rate for Payer: Heritage Provider Network Senior |
$244.50
|
| Rate for Payer: Heritage Provider Network Senior |
$50.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.71
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$188.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$39.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$71.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.33
|
| Rate for Payer: Multiplan Commercial |
$296.25
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.71
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.71
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$8.33
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$11.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.48
|
| Rate for Payer: Vantage Medical Group Senior |
$7.71
|
| Rate for Payer: Vantage Medical Group Senior |
$7.71
|
|
|
HC CULTURE GASTRIC ASPIRATE
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911506
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$251.16
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE GASTRIC ASPIRATE
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911506
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$81.69 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$241.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| 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 Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.00
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$52.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$186.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$40.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE G.C.
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911631
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$251.16
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE G.C.
|
Facility
|
OP
|
$82.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911631
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$81.69 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$241.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$50.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| 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 Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$53.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$50.76
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$50.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$186.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$39.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE GRAM NEGATIVE ID
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912411
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$76.64 |
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
| Rate for Payer: Adventist Health Commercial |
$14.40
|
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$123.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$44.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| 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 Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.64
|
| Rate for Payer: Blue Shield of California Commercial |
$65.03
|
| Rate for Payer: Blue Shield of California Commercial |
$65.03
|
| Rate for Payer: Blue Shield of California EPN |
$52.16
|
| Rate for Payer: Blue Shield of California EPN |
$52.16
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$130.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$46.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.00
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$123.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.57
|
| Rate for Payer: Heritage Provider Network Senior |
$123.80
|
| Rate for Payer: Heritage Provider Network Senior |
$44.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$95.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$34.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
| Rate for Payer: Multiplan Commercial |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.08
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.08
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$8.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC CULTURE GRAM NEGATIVE ID
|
Facility
|
IP
|
$200.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912411
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$36.20 |
| Max. Negotiated Rate |
$150.00 |
| Rate for Payer: Adventist Health Commercial |
$40.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$128.80
|
| Rate for Payer: Cash Price |
$90.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$135.40
|
| Rate for Payer: Heritage Provider Network Senior |
$135.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$36.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.00
|
| Rate for Payer: Multiplan Commercial |
$150.00
|
|
|
HC CULTURE GRAM POSITIVE ID
|
Facility
|
OP
|
$72.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912410
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.08 |
| Max. Negotiated Rate |
$76.64 |
| Rate for Payer: Adventist Health Commercial |
$14.40
|
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$101.97
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$44.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.12
|
| 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 Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$76.64
|
| Rate for Payer: Blue Shield of California Commercial |
$65.03
|
| Rate for Payer: Blue Shield of California Commercial |
$65.03
|
| Rate for Payer: Blue Shield of California EPN |
$52.16
|
| Rate for Payer: Blue Shield of California EPN |
$52.16
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$32.40
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$107.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$46.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$97.35
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.08
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$102.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$44.57
|
| Rate for Payer: Heritage Provider Network Senior |
$102.14
|
| Rate for Payer: Heritage Provider Network Senior |
$44.57
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$78.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$34.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.83
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
| Rate for Payer: Multiplan Commercial |
$54.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.08
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.08
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$8.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$12.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
HC CULTURE GRAM POSITIVE ID
|
Facility
|
IP
|
$165.00
|
|
|
Service Code
|
CPT 87077
|
| Hospital Charge Code |
900912410
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$29.86 |
| Max. Negotiated Rate |
$123.75 |
| Rate for Payer: Adventist Health Commercial |
$33.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.26
|
| Rate for Payer: Cash Price |
$74.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$111.70
|
| Rate for Payer: Heritage Provider Network Senior |
$111.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.25
|
| Rate for Payer: Multiplan Commercial |
$123.75
|
|
|
HC CULTURE GROUP B STREP
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912406
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$81.69 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$241.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| 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 Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.00
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$52.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$186.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$40.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE GROUP B STREP
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912406
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$251.16
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE,INVASIVE LOWER RESP
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912408
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$251.16
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE,INVASIVE LOWER RESP
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900912408
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$81.69 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$241.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| 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 Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.00
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$52.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$186.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$40.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE JEJUNUM AEROBIC
|
Facility
|
OP
|
$390.00
|
|
|
Service Code
|
CPT 87071
|
| Hospital Charge Code |
900911507
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.89 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Adventist Health Commercial |
$7.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$241.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.75
|
| Rate for Payer: Blue Shield of California Commercial |
$75.92
|
| Rate for Payer: Blue Shield of California Commercial |
$75.92
|
| Rate for Payer: Blue Shield of California EPN |
$60.89
|
| Rate for Payer: Blue Shield of California EPN |
$60.89
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.01
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.89
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$24.14
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$18.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$186.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13.25
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.89
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.89
|
| Rate for Payer: TriValley Medical Group Senior |
$9.89
|
| Rate for Payer: TriValley Medical Group Senior |
$9.89
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.88
|
| Rate for Payer: Vantage Medical Group Senior |
$9.89
|
| Rate for Payer: Vantage Medical Group Senior |
$9.89
|
|
|
HC CULTURE JEJUNUM AEROBIC
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87071
|
| Hospital Charge Code |
900911507
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$251.16
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE JEJUNUM ANAEROBIC
|
Facility
|
IP
|
$429.00
|
|
|
Service Code
|
CPT 87073
|
| Hospital Charge Code |
900911508
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$77.65 |
| Max. Negotiated Rate |
$321.75 |
| Rate for Payer: Adventist Health Commercial |
$85.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$276.28
|
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$290.43
|
| Rate for Payer: Heritage Provider Network Senior |
$290.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.25
|
| Rate for Payer: Multiplan Commercial |
$321.75
|
|
|
HC CULTURE JEJUNUM ANAEROBIC
|
Facility
|
OP
|
$429.00
|
|
|
Service Code
|
CPT 87073
|
| Hospital Charge Code |
900911508
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$9.66 |
| Max. Negotiated Rate |
$321.75 |
| Rate for Payer: Adventist Health Commercial |
$85.80
|
| Rate for Payer: Adventist Health Commercial |
$7.80
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24.10
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$265.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.75
|
| Rate for Payer: Blue Shield of California Commercial |
$75.92
|
| Rate for Payer: Blue Shield of California Commercial |
$75.92
|
| Rate for Payer: Blue Shield of California EPN |
$60.89
|
| Rate for Payer: Blue Shield of California EPN |
$60.89
|
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: Cash Price |
$193.05
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cash Price |
$17.55
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$278.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$253.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.01
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.66
|
| Rate for Payer: EPIC Health Plan Medicare |
$9.66
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$265.55
|
| Rate for Payer: Heritage Provider Network Senior |
$24.14
|
| Rate for Payer: Heritage Provider Network Senior |
$265.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$18.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$204.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$77.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12.94
|
| Rate for Payer: Multiplan Commercial |
$29.25
|
| Rate for Payer: Multiplan Commercial |
$321.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.66
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.66
|
| Rate for Payer: TriValley Medical Group Senior |
$9.66
|
| Rate for Payer: TriValley Medical Group Senior |
$9.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.43
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.43
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.43
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.63
|
| Rate for Payer: Vantage Medical Group Senior |
$9.66
|
| Rate for Payer: Vantage Medical Group Senior |
$9.66
|
|
|
HC CULTURE LEGIONELLA
|
Facility
|
IP
|
$390.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911524
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$70.59 |
| Max. Negotiated Rate |
$292.50 |
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$251.16
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Heritage Provider Network Commercial |
$264.03
|
| Rate for Payer: Heritage Provider Network Senior |
$264.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
|
|
HC CULTURE LEGIONELLA
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911524
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$81.69 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$241.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| 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 Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.00
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$52.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$186.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$40.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
|
HC CULTURE MISCELLANEOUS
|
Facility
|
OP
|
$84.00
|
|
|
Service Code
|
CPT 87070
|
| Hospital Charge Code |
900911509
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$8.62 |
| Max. Negotiated Rate |
$81.69 |
| Rate for Payer: Adventist Health Commercial |
$16.80
|
| Rate for Payer: Adventist Health Commercial |
$78.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$241.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$51.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.93
|
| 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 Medi-Cal |
$9.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$81.69
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California Commercial |
$69.29
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Blue Shield of California EPN |
$55.58
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$37.80
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cash Price |
$175.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$253.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$54.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.10
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: EPIC Health Plan Medicare |
$8.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$241.41
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.00
|
| Rate for Payer: Heritage Provider Network Senior |
$241.41
|
| Rate for Payer: Heritage Provider Network Senior |
$52.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$186.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$40.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$70.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$97.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.55
|
| Rate for Payer: Multiplan Commercial |
$292.50
|
| Rate for Payer: Multiplan Commercial |
$63.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$8.62
|
| Rate for Payer: TriValley Medical Group Senior |
$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 All Other HMO/non HMO |
$9.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$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 Commercial/Exchange |
$12.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.48
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
| Rate for Payer: Vantage Medical Group Senior |
$8.62
|
|
