|
HC LAB REF EASTERN EQUINE AB IGG
|
Facility
|
IP
|
$18.75
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
900911467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$14.06 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.69
|
| Rate for Payer: Heritage Provider Network Senior |
$12.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| Rate for Payer: Multiplan Commercial |
$14.06
|
|
|
HC LAB REF EASTERN EQUINE AB IGG
|
Facility
|
OP
|
$18.75
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
900911467
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$103.02
|
| Rate for Payer: Blue Shield of California EPN |
$80.54
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.19
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.61
|
| Rate for Payer: Heritage Provider Network Senior |
$11.61
|
| Rate for Payer: Humana Medicare |
$13.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.62
|
| Rate for Payer: Multiplan Commercial |
$14.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.19
|
| Rate for Payer: TriValley Medical Group Senior |
$13.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC LAB REF EASTERN EQUINE AB IGM
|
Facility
|
IP
|
$18.75
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
900912653
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$14.06 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.69
|
| Rate for Payer: Heritage Provider Network Senior |
$12.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| Rate for Payer: Multiplan Commercial |
$14.06
|
|
|
HC LAB REF EASTERN EQUINE AB IGM
|
Facility
|
OP
|
$18.75
|
|
|
Service Code
|
CPT 86652
|
| Hospital Charge Code |
900912653
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.39 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.75
|
| Rate for Payer: Aetna of CA Gatekeeper |
$38.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$103.02
|
| Rate for Payer: Blue Shield of California EPN |
$80.54
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cash Price |
$8.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.51
|
| Rate for Payer: Dignity Health Senior |
$13.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.19
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.61
|
| Rate for Payer: Heritage Provider Network Senior |
$11.61
|
| Rate for Payer: Humana Medicare |
$13.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.62
|
| Rate for Payer: Multiplan Commercial |
$14.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.19
|
| Rate for Payer: TriValley Medical Group Senior |
$13.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.51
|
| Rate for Payer: Vantage Medical Group Senior |
$13.19
|
|
|
HC LAB REF ECHINOCOCCUS IGE
|
Facility
|
OP
|
$11.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912520
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.15 |
| Max. Negotiated Rate |
$132.31 |
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.18
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$132.31
|
| Rate for Payer: Blue Shield of California Commercial |
$40.81
|
| Rate for Payer: Blue Shield of California EPN |
$31.90
|
| Rate for Payer: Cash Price |
$5.36
|
| Rate for Payer: Cash Price |
$5.36
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.74
|
| Rate for Payer: EPIC Health Plan Medicare |
$5.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.37
|
| Rate for Payer: Heritage Provider Network Senior |
$7.37
|
| Rate for Payer: Humana Medicare |
$5.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$8.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.22
|
| Rate for Payer: TriValley Medical Group Senior |
$5.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC LAB REF ECHINOCOCCUS IGE
|
Facility
|
IP
|
$11.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912520
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.15 |
| Max. Negotiated Rate |
$8.92 |
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.18
|
| Rate for Payer: Cash Price |
$5.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.06
|
| Rate for Payer: Heritage Provider Network Senior |
$8.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.98
|
| Rate for Payer: Multiplan Commercial |
$8.92
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A10
|
Facility
|
IP
|
$18.13
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900911761
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.27
|
| Rate for Payer: Heritage Provider Network Senior |
$12.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A10
|
Facility
|
OP
|
$18.13
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900911761
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.78
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.22
|
| Rate for Payer: Heritage Provider Network Senior |
$11.22
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A16
|
Facility
|
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912732
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A16
|
Facility
|
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912732
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A2
|
Facility
|
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912727
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A2
|
Facility
|
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912727
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A4
|
Facility
|
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912728
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A4
|
Facility
|
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912728
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A7
|
Facility
|
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912729
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A7
|
Facility
|
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912729
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A9
|
Facility
|
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912730
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE A9
|
Facility
|
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912730
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B1
|
Facility
|
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900911762
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B1
|
Facility
|
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900911762
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B2
|
Facility
|
IP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912731
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$13.60 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.28
|
| Rate for Payer: Heritage Provider Network Senior |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B2
|
Facility
|
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912731
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B3
|
Facility
|
IP
|
$15.70
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912733
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$11.78 |
| Rate for Payer: Adventist Health Commercial |
$3.14
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.79
|
| Rate for Payer: Cash Price |
$7.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.63
|
| Rate for Payer: Heritage Provider Network Senior |
$10.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.92
|
| Rate for Payer: Multiplan Commercial |
$11.78
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B3
|
Facility
|
OP
|
$15.70
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912733
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.84 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.14
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$7.07
|
| Rate for Payer: Cash Price |
$7.07
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.72
|
| Rate for Payer: Heritage Provider Network Senior |
$9.72
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$11.78
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
|
HC LAB REF ENTEROVIRUS AB COXSACKIE B4
|
Facility
|
OP
|
$18.14
|
|
|
Service Code
|
CPT 86658
|
| Hospital Charge Code |
900912734
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$110.39 |
| Rate for Payer: Adventist Health Commercial |
$3.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$12.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$110.39
|
| Rate for Payer: Blue Shield of California Commercial |
$101.74
|
| Rate for Payer: Blue Shield of California EPN |
$79.53
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cash Price |
$8.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$11.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.33
|
| Rate for Payer: Dignity Health Senior |
$13.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.23
|
| Rate for Payer: Heritage Provider Network Senior |
$11.23
|
| Rate for Payer: Humana Medicare |
$13.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$18.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.42
|
| Rate for Payer: Multiplan Commercial |
$13.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.03
|
| Rate for Payer: TriValley Medical Group Senior |
$13.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.33
|
| Rate for Payer: Vantage Medical Group Senior |
$13.03
|
|
