|
HC NUCLEIC ACID ID E.FAECALIS
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912456
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID E.FAECALIS
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912456
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID ENTEROBACTER
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912469
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID ENTEROBACTER
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912469
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID IMP
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912481
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID IMP
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912481
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID K.OXYTOCA
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912471
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID K.OXYTOCA
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912471
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID KPC
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912480
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID KPC
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912480
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID K.PNEUMONIAE
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912475
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID K.PNEUMONIAE
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912475
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID LISTERIA
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912457
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID LISTERIA
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912457
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID MECA
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912464
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID MECA
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912464
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID NDM
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912478
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID NDM
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912478
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID OXA
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912479
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID OXA
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912479
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID P.AERUGINOSA
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912474
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID P.AERUGINOSA
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912474
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID PROTEUS
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912473
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
|
HC NUCLEIC ACID ID PROTEUS
|
Facility
|
IP
|
$172.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912473
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$31.13 |
| Max. Negotiated Rate |
$129.00 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$110.77
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$116.44
|
| Rate for Payer: Heritage Provider Network Senior |
$116.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
|
|
HC NUCLEIC ACID ID S.AGALACTIAE
|
Facility
|
OP
|
$42.00
|
|
|
Service Code
|
CPT 87149
|
| Hospital Charge Code |
900912454
|
|
Hospital Revenue Code
|
300
|
| Min. Negotiated Rate |
$7.60 |
| Max. Negotiated Rate |
$190.23 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$106.30
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$190.23
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California Commercial |
$161.40
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Blue Shield of California EPN |
$129.45
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$18.90
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cash Price |
$77.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$111.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$27.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.80
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: EPIC Health Plan Medicare |
$20.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$106.47
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.00
|
| Rate for Payer: Heritage Provider Network Senior |
$106.47
|
| Rate for Payer: Heritage Provider Network Senior |
$26.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$20.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$82.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Multiplan Commercial |
$31.50
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: TriValley Medical Group Senior |
$20.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
| Rate for Payer: Vantage Medical Group Senior |
$20.05
|
|
