|
HC LAB REF IMMUNO FIXATION ELECTRO UR
|
Facility
IP
|
$42.04
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
900912719
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.61 |
| Max. Negotiated Rate |
$31.53 |
| Rate for Payer: Adventist Health Commercial |
$8.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.88
|
| Rate for Payer: Cash Price |
$18.92
|
| Rate for Payer: Heritage Provider Network Commercial |
$28.46
|
| Rate for Payer: Heritage Provider Network Senior |
$28.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.51
|
| Rate for Payer: Multiplan Commercial |
$31.53
|
|
|
HC LAB REF IMMUNO FIXATION ELECTRO UR
|
Facility
OP
|
$42.04
|
|
|
Service Code
|
CPT 86335
|
| Hospital Charge Code |
900912719
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$7.61 |
| Max. Negotiated Rate |
$229.19 |
| Rate for Payer: Adventist Health Commercial |
$8.41
|
| Rate for Payer: Aetna of CA Gatekeeper |
$85.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$44.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$32.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$29.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$116.48
|
| Rate for Payer: Blue Shield of California Commercial |
$229.19
|
| Rate for Payer: Blue Shield of California EPN |
$179.17
|
| Rate for Payer: Cash Price |
$18.92
|
| Rate for Payer: Cash Price |
$18.92
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.28
|
| Rate for Payer: Dignity Health Senior |
$29.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.33
|
| Rate for Payer: EPIC Health Plan Medicare |
$29.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.02
|
| Rate for Payer: Heritage Provider Network Senior |
$26.02
|
| Rate for Payer: Humana Medicare |
$29.35
|
| Rate for Payer: IEHP Medi-Cal |
$40.70
|
| Rate for Payer: IEHP Medicare Advantage |
$29.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$55.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.61
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.98
|
| Rate for Payer: Multiplan Commercial |
$31.53
|
| Rate for Payer: TriValley Medical Group Commercial |
$29.35
|
| Rate for Payer: TriValley Medical Group Senior |
$29.35
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$31.70
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$31.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.28
|
| Rate for Payer: Vantage Medical Group Senior |
$29.35
|
|
|
HC LAB REF INFLUENZA A AB IGM
|
Facility
OP
|
$14.75
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900912806
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$115.63 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.63
|
| Rate for Payer: Blue Shield of California Commercial |
$105.87
|
| Rate for Payer: Blue Shield of California EPN |
$82.77
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.90
|
| Rate for Payer: Dignity Health Senior |
$13.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.59
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.13
|
| Rate for Payer: Heritage Provider Network Senior |
$9.13
|
| Rate for Payer: Humana Medicare |
$13.55
|
| Rate for Payer: IEHP Medi-Cal |
$18.80
|
| Rate for Payer: IEHP Medicare Advantage |
$13.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.07
|
| Rate for Payer: Multiplan Commercial |
$11.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.55
|
| Rate for Payer: TriValley Medical Group Senior |
$13.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: Vantage Medical Group Senior |
$13.55
|
|
|
HC LAB REF INFLUENZA A AB IGM
|
Facility
IP
|
$14.75
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900912806
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$11.06 |
| Rate for Payer: Adventist Health Commercial |
$2.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$10.13
|
| Rate for Payer: Cash Price |
$6.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.99
|
| Rate for Payer: Heritage Provider Network Senior |
$9.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.69
|
| Rate for Payer: Multiplan Commercial |
$11.06
|
|
|
HC LAB REF INFLUENZA B AB IGM
|
Facility
IP
|
$7.50
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900912807
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$5.62 |
| Rate for Payer: Adventist Health Commercial |
$1.50
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.15
|
| Rate for Payer: Cash Price |
$3.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.08
|
| Rate for Payer: Heritage Provider Network Senior |
$5.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.88
|
| Rate for Payer: Multiplan Commercial |
$5.62
|
|
|
HC LAB REF INFLUENZA B AB IGM
|
Facility
OP
|
$7.50
|
|
|
Service Code
|
CPT 86710
|
| Hospital Charge Code |
900912807
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$1.36 |
| Max. Negotiated Rate |
$115.63 |
| Rate for Payer: Adventist Health Commercial |
$1.50
|
| Rate for Payer: Aetna of CA Gatekeeper |
$39.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$115.63
|
| Rate for Payer: Blue Shield of California Commercial |
$105.87
|
| Rate for Payer: Blue Shield of California EPN |
$82.77
|
| Rate for Payer: Cash Price |
$3.38
|
| Rate for Payer: Cash Price |
$3.38
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.90
|
| Rate for Payer: Dignity Health Senior |
$13.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.88
|
| Rate for Payer: EPIC Health Plan Medicare |
$13.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.64
|
| Rate for Payer: Heritage Provider Network Senior |
$4.64
|
| Rate for Payer: Humana Medicare |
$13.55
|
| Rate for Payer: IEHP Medi-Cal |
$18.80
|
| Rate for Payer: IEHP Medicare Advantage |
$13.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.07
|
| Rate for Payer: Multiplan Commercial |
$5.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$13.55
|
| Rate for Payer: TriValley Medical Group Senior |
$13.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$14.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.90
|
| Rate for Payer: Vantage Medical Group Senior |
$13.55
|
|
|
HC LAB REF INTERPHASE IN SITU HYBRIDIZATI
|
Facility
IP
|
$49.86
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900912582
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$37.40 |
| Rate for Payer: Adventist Health Commercial |
$9.97
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.25
|
| Rate for Payer: Cash Price |
$22.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$33.76
|
| Rate for Payer: Heritage Provider Network Senior |
$33.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.46
|
| Rate for Payer: Multiplan Commercial |
$37.40
|
|
|
HC LAB REF INTERPHASE IN SITU HYBRIDIZATI
|
Facility
OP
|
$49.86
|
|
|
Service Code
|
CPT 88275
|
| Hospital Charge Code |
900912582
|
|
Hospital Revenue Code
|
310
|
| Min. Negotiated Rate |
$9.02 |
| Max. Negotiated Rate |
$2,190.93 |
| Rate for Payer: Adventist Health Commercial |
$9.97
|
| Rate for Payer: Aetna of CA Gatekeeper |
$116.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.25
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$51.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,190.93
|
| Rate for Payer: Blue Shield of California Commercial |
$313.65
|
| Rate for Payer: Blue Shield of California EPN |
$245.20
|
| Rate for Payer: Cash Price |
$22.44
|
| Rate for Payer: Cash Price |
$22.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$32.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$76.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.31
|
| Rate for Payer: Dignity Health Senior |
$51.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.41
|
| Rate for Payer: EPIC Health Plan Medicare |
$51.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$30.86
|
| Rate for Payer: Heritage Provider Network Senior |
$30.86
|
| Rate for Payer: Humana Medicare |
$51.19
|
| Rate for Payer: IEHP Medi-Cal |
$49.42
|
| Rate for Payer: IEHP Medicare Advantage |
$51.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$97.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$64.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$64.50
|
| Rate for Payer: Multiplan Commercial |
$37.40
|
| Rate for Payer: TriValley Medical Group Commercial |
$51.19
|
| Rate for Payer: TriValley Medical Group Senior |
$51.19
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$55.28
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$55.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$76.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.31
|
| Rate for Payer: Vantage Medical Group Senior |
$51.19
|
|
|
HC LAB REF ISLET CELL ANTIBODIES
|
Facility
IP
|
$163.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900911237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$29.50 |
| Max. Negotiated Rate |
$122.25 |
| Rate for Payer: Adventist Health Commercial |
$32.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$111.98
|
| Rate for Payer: Cash Price |
$73.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$110.35
|
| Rate for Payer: Heritage Provider Network Senior |
$110.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.75
|
| Rate for Payer: Multiplan Commercial |
$122.25
|
|
|
HC LAB REF ISLET CELL ANTIBODIES
|
Facility
OP
|
$163.00
|
|
|
Service Code
|
CPT 86341
|
| Hospital Charge Code |
900911237
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$23.57 |
| Max. Negotiated Rate |
$129.80 |
| Rate for Payer: Adventist Health Commercial |
$32.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$48.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$111.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$35.36
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$23.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.71
|
| Rate for Payer: Blue Shield of California Commercial |
$129.80
|
| Rate for Payer: Blue Shield of California EPN |
$101.47
|
| Rate for Payer: Cash Price |
$73.35
|
| Rate for Payer: Cash Price |
$73.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$105.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.93
|
| Rate for Payer: Dignity Health Senior |
$23.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$23.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$100.90
|
| Rate for Payer: Heritage Provider Network Senior |
$100.90
|
| Rate for Payer: Humana Medicare |
$23.57
|
| Rate for Payer: IEHP Medi-Cal |
$28.22
|
| Rate for Payer: IEHP Medicare Advantage |
$23.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$44.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.70
|
| Rate for Payer: Multiplan Commercial |
$122.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$23.57
|
| Rate for Payer: TriValley Medical Group Senior |
$23.57
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$25.45
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$25.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$23.57
|
|
|
HC LAB REF KIDNEY BEAN (RED) IGE
|
Facility
IP
|
$11.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912529
|
|
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 KIDNEY BEAN (RED) IGE
|
Facility
OP
|
$11.90
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900912529
|
|
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: AlphaCare Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: AlphaCare 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: IEHP Medi-Cal |
$7.24
|
| Rate for Payer: 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 LCM IGG
|
Facility
OP
|
$39.10
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
900911470
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.08 |
| Max. Negotiated Rate |
$107.74 |
| Rate for Payer: Adventist Health Commercial |
$7.82
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.74
|
| Rate for Payer: Blue Shield of California Commercial |
$100.51
|
| Rate for Payer: Blue Shield of California EPN |
$78.57
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Senior |
$12.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.42
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.20
|
| Rate for Payer: Heritage Provider Network Senior |
$24.20
|
| Rate for Payer: Humana Medicare |
$12.87
|
| Rate for Payer: IEHP Medi-Cal |
$17.85
|
| Rate for Payer: IEHP Medicare Advantage |
$12.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.22
|
| Rate for Payer: Multiplan Commercial |
$29.32
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.87
|
| Rate for Payer: TriValley Medical Group Senior |
$12.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC LAB REF LCM IGG
|
Facility
IP
|
$39.10
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
900911470
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.08 |
| Max. Negotiated Rate |
$29.32 |
| Rate for Payer: Adventist Health Commercial |
$7.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26.86
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.78
|
| Rate for Payer: Multiplan Commercial |
$29.32
|
|
|
HC LAB REF LCM IGM
|
Facility
OP
|
$39.10
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
900912723
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.08 |
| Max. Negotiated Rate |
$107.74 |
| Rate for Payer: Adventist Health Commercial |
$7.82
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.43
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.74
|
| Rate for Payer: Blue Shield of California Commercial |
$100.51
|
| Rate for Payer: Blue Shield of California EPN |
$78.57
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.16
|
| Rate for Payer: Dignity Health Senior |
$12.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.42
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.20
|
| Rate for Payer: Heritage Provider Network Senior |
$24.20
|
| Rate for Payer: Humana Medicare |
$12.87
|
| Rate for Payer: IEHP Medi-Cal |
$17.85
|
| Rate for Payer: IEHP Medicare Advantage |
$12.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.22
|
| Rate for Payer: Multiplan Commercial |
$29.32
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.87
|
| Rate for Payer: TriValley Medical Group Senior |
$12.87
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.87
|
|
|
HC LAB REF LCM IGM
|
Facility
IP
|
$39.10
|
|
|
Service Code
|
CPT 86727
|
| Hospital Charge Code |
900912723
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$7.08 |
| Max. Negotiated Rate |
$29.32 |
| Rate for Payer: Adventist Health Commercial |
$7.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$26.86
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.78
|
| Rate for Payer: Multiplan Commercial |
$29.32
|
|
|
HC LAB REF LIDOCAINE
|
Facility
IP
|
$16.24
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
900910404
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$12.18 |
| Rate for Payer: Adventist Health Commercial |
$3.25
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.16
|
| Rate for Payer: Cash Price |
$7.31
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.99
|
| Rate for Payer: Heritage Provider Network Senior |
$10.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.06
|
| Rate for Payer: Multiplan Commercial |
$12.18
|
|
|
HC LAB REF LIDOCAINE
|
Facility
OP
|
$16.24
|
|
|
Service Code
|
CPT 80176
|
| Hospital Charge Code |
900910404
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.94 |
| Max. Negotiated Rate |
$122.90 |
| Rate for Payer: Adventist Health Commercial |
$3.25
|
| Rate for Payer: Aetna of CA Gatekeeper |
$42.74
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.16
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$122.90
|
| Rate for Payer: Blue Shield of California Commercial |
$114.71
|
| Rate for Payer: Blue Shield of California EPN |
$89.67
|
| Rate for Payer: Cash Price |
$7.31
|
| Rate for Payer: Cash Price |
$7.31
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.16
|
| Rate for Payer: Dignity Health Senior |
$14.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Medicare |
$14.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.05
|
| Rate for Payer: Heritage Provider Network Senior |
$10.05
|
| Rate for Payer: Humana Medicare |
$14.69
|
| Rate for Payer: IEHP Medi-Cal |
$20.37
|
| Rate for Payer: IEHP Medicare Advantage |
$14.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.51
|
| Rate for Payer: Multiplan Commercial |
$12.18
|
| Rate for Payer: TriValley Medical Group Commercial |
$14.69
|
| Rate for Payer: TriValley Medical Group Senior |
$14.69
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$15.86
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$15.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.16
|
| Rate for Payer: Vantage Medical Group Senior |
$14.69
|
|
|
HC LAB REF LISTERIA AB
|
Facility
IP
|
$98.57
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
900911391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$17.84 |
| Max. Negotiated Rate |
$73.93 |
| Rate for Payer: Adventist Health Commercial |
$19.71
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.72
|
| Rate for Payer: Cash Price |
$44.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$66.73
|
| Rate for Payer: Heritage Provider Network Senior |
$66.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.64
|
| Rate for Payer: Multiplan Commercial |
$73.93
|
|
|
HC LAB REF LISTERIA AB
|
Facility
OP
|
$98.57
|
|
|
Service Code
|
CPT 86609
|
| Hospital Charge Code |
900911391
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.88 |
| Max. Negotiated Rate |
$107.86 |
| Rate for Payer: Adventist Health Commercial |
$19.71
|
| Rate for Payer: Aetna of CA Gatekeeper |
$37.48
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$67.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.86
|
| Rate for Payer: Blue Shield of California Commercial |
$100.62
|
| Rate for Payer: Blue Shield of California EPN |
$78.66
|
| Rate for Payer: Cash Price |
$44.36
|
| Rate for Payer: Cash Price |
$44.36
|
| Rate for Payer: Cigna of CA HMO/PPO |
$64.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.17
|
| Rate for Payer: Dignity Health Senior |
$12.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$64.07
|
| Rate for Payer: EPIC Health Plan Medicare |
$12.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$61.01
|
| Rate for Payer: Heritage Provider Network Senior |
$61.01
|
| Rate for Payer: Humana Medicare |
$12.88
|
| Rate for Payer: IEHP Medi-Cal |
$17.86
|
| Rate for Payer: IEHP Medicare Advantage |
$12.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.23
|
| Rate for Payer: Multiplan Commercial |
$73.93
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.88
|
| Rate for Payer: TriValley Medical Group Senior |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$13.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.17
|
| Rate for Payer: Vantage Medical Group Senior |
$12.88
|
|
|
HC LAB REF MERCURY URINE
|
Facility
IP
|
$20.75
|
|
|
Service Code
|
CPT 83830
|
| Hospital Charge Code |
900911144
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$15.56 |
| Rate for Payer: Adventist Health Commercial |
$4.15
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.26
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.05
|
| Rate for Payer: Heritage Provider Network Senior |
$14.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.19
|
| Rate for Payer: Multiplan Commercial |
$15.56
|
|
|
HC LAB REF MERCURY URINE
|
Facility
OP
|
$20.75
|
|
|
Service Code
|
CPT 83830
|
| Hospital Charge Code |
900911144
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$3.76 |
| Max. Negotiated Rate |
$17.64 |
| Rate for Payer: Adventist Health Commercial |
$4.15
|
| Rate for Payer: Aetna of CA Gatekeeper |
$11.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$14.26
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.41
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.56
|
| Rate for Payer: Blue Shield of California Commercial |
$12.89
|
| Rate for Payer: Blue Shield of California EPN |
$12.18
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.64
|
| Rate for Payer: Dignity Health Senior |
$17.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.84
|
| Rate for Payer: Heritage Provider Network Senior |
$12.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$10.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.19
|
| Rate for Payer: Multiplan Commercial |
$15.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.64
|
| Rate for Payer: Vantage Medical Group Senior |
$17.64
|
|
|
HC LAB REF METHEMALBUMIN
|
Facility
IP
|
$103.00
|
|
|
Service Code
|
CPT 83857
|
| Hospital Charge Code |
900911067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$18.64 |
| Max. Negotiated Rate |
$77.25 |
| Rate for Payer: Adventist Health Commercial |
$20.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$70.76
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Heritage Provider Network Commercial |
$69.73
|
| Rate for Payer: Heritage Provider Network Senior |
$69.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.75
|
| Rate for Payer: Multiplan Commercial |
$77.25
|
|
|
HC LAB REF METHEMALBUMIN
|
Facility
OP
|
$103.00
|
|
|
Service Code
|
CPT 83857
|
| Hospital Charge Code |
900911067
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.74 |
| Max. Negotiated Rate |
$89.88 |
| Rate for Payer: Adventist Health Commercial |
$20.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$31.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$70.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$89.88
|
| Rate for Payer: Blue Shield of California Commercial |
$83.91
|
| Rate for Payer: Blue Shield of California EPN |
$65.59
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cash Price |
$46.35
|
| Rate for Payer: Cigna of CA HMO/PPO |
$66.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.81
|
| Rate for Payer: Dignity Health Senior |
$10.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$10.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$63.76
|
| Rate for Payer: Heritage Provider Network Senior |
$63.76
|
| Rate for Payer: Humana Medicare |
$10.74
|
| Rate for Payer: IEHP Medi-Cal |
$14.88
|
| Rate for Payer: IEHP Medicare Advantage |
$10.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$20.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.53
|
| Rate for Payer: Multiplan Commercial |
$77.25
|
| Rate for Payer: TriValley Medical Group Commercial |
$10.74
|
| Rate for Payer: TriValley Medical Group Senior |
$10.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$11.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$11.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC LAB REF METHEMOGLOBIN
|
Facility
IP
|
$8.62
|
|
|
Service Code
|
CPT 83050
|
| Hospital Charge Code |
900910295
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$1.56 |
| Max. Negotiated Rate |
$6.46 |
| Rate for Payer: Adventist Health Commercial |
$1.72
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.92
|
| Rate for Payer: Cash Price |
$3.88
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.84
|
| Rate for Payer: Heritage Provider Network Senior |
$5.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Multiplan Commercial |
$6.46
|
|
