Common use of PacifiCare Protocols Clause in Contracts

PacifiCare Protocols. For Customers enrolled in Benefit Plans issued or administered by a subsidiary of either PacifiCare Health Plan Administrators, Inc. or PacifiCare Health Systems, LLC (“PacifiCare Customers”), Facility will be subject to the Protocols described in or made available through the PacifiCare Provider Policy and Procedure Manual (“PacifiCare Manual”). When this Agreement refers to the Administrative Manual or Guide, it is also referring to the PacifiCare Manual. The PacifiCare Manual will be made available to Facility on line or upon request. In the event of any conflict between this Agreement or the UnitedHealthcare Physician, Health Care Professional, Facility and Ancillary Provider Administrative Guide or other UnitedHealthcare administrative protocols, and the PacifiCare Manual, in connection with any matter pertaining to a PacifiCare Customer, the PacifiCare Manual will govern, unless applicable statutes and regulations dictate otherwise. United may make changes to the Administrative Manual or Guide or PacifiCare Manual or other administrative protocols upon 30 days’ electronic or written notice to Facility. UnitedHealthcare Facility Agreement Confidential and Proprietary UHC/FPA[ANC][State][Nat’l].08.07 0507 * Confidential Treatment Requested by Celera Corporation* Unless another appendix to this agreement applies specifically to a particular Benefit Plan as it covers a particular customer, the provisions of this appendix apply to covered services rendered by you to Customers covered by Benefit Plans sponsored, issued or administered by all participating entities. Unless specifically indicated otherwise, amounts listed in the fee schedule represent global fees and may be subject to reductions based on appropriate modifier (for example, professional and technical modifiers). Any co-payment, deductible or coinsurance that the Customer is responsible to pay under the Customer’s Benefit Plan will be subtracted from the listed amount in determining the amount to be paid by the Payer. The actual payment amount is also subject to matters described in this Agreement, such as the reimbursement policies. Please remember that this information is subject to the confidentiality provisions of this Agreement. LAB - PATHOLOGY Current Year CMS RBRVS (0000000) [* * *] OFFICE LAB Current Year CMS Clinical Lab Schedule - National Limit [* * *] CLINICAL LABORATORY Current Year CMS Clinical Lab Schedule - National Limit [* * *] New Technology: United acknowledges that Facility may develop and/or provide new technologies and/or new methodologies during the term of this Agreement. In addition, both parties acknowledge that there may be other circumstances in which there is no fee in the fee schedule, or where no relative value units have been established for a particular service. Facility shall notify United when such new technologies and/or methodologies are available, or no fee or relative value units have been established for a particular service and the parties shall develop the fee and/or relative value units associated with such new technologies and/or methodologies and/or services. The methodology for developing new fees or relative value units shall be as follows: (a) [* * *] (b) [* * *] UnitedHealthcare Facility Agreement Confidential and Proprietary UHC/FPA[ANC][State][Nat’l].08.07 0507 * Confidential Treatment Requested by Celera Corporation* (c) [* * *] (d) [* * *] (e) [* * *] Commercial [* * *] Medicare [* * *] UnitedHealthcare Facility Agreement Confidential and Proprietary UHC/FPA[ANC][Nat’l].08.07[State] 0807 * Confidential Treatment Requested by Celera Corporation*

PacifiCare Protocols. For Customers enrolled in Benefit Plans issued or administered by a subsidiary of either PacifiCare Health Plan Administrators, Inc. or PacifiCare Health Systems, LLC (“PacifiCare Customers”), Facility will be subject to the Protocols described in or made available through the PacifiCare Provider Policy and Procedure Manual (“PacifiCare Manual”). When this Agreement refers to the Administrative Manual or Guide, it is also referring to the PacifiCare Manual. The PacifiCare Manual will be made available to Facility on line or upon request. In the event of any conflict between this Agreement or the UnitedHealthcare Physician, Health Care Professional, Facility and Ancillary Provider Administrative Guide or other UnitedHealthcare administrative protocols, and the PacifiCare Manual, in connection with any matter pertaining to a PacifiCare Customer, the PacifiCare Manual will govern, unless applicable statutes and regulations dictate otherwise. United may make changes to the Administrative Manual or Guide or PacifiCare Manual or other administrative protocols upon 30 days’ electronic or written notice to Facility. UnitedHealthcare Facility Agreement Confidential and Proprietary UHC/FPA[ANC][State][Nat’l].08.07 0507 * Confidential Treatment Requested by Celera Corporation* [***] indicates material that has been omitted pursuant to a request for confidential treatment. The omitted material has been filed separately with the Securities and Exchange Commission. Unless another appendix to this agreement applies specifically to a particular Benefit Plan as it covers a particular customer, the provisions of this appendix apply to covered services rendered by you to Customers covered by Benefit Plans sponsored, issued or administered by all participating entities. Unless specifically indicated otherwise, amounts listed in the fee schedule represent global fees and may be subject to reductions based on appropriate modifier (for example, professional and technical modifiers). Any co-payment, deductible or coinsurance that the Customer is responsible to pay under the Customer’s Benefit Plan will be subtracted from the listed amount in determining the amount to be paid by the Payer. The actual payment amount is also subject to matters described in this Agreement, such as the reimbursement policies. Please remember that this information is subject to the confidentiality provisions of this Agreement. LAB - PATHOLOGY Current Year CMS RBRVS (0000000) [* * *] OFFICE LAB Current Year CMS Clinical Lab Schedule - National Limit [* * *] CLINICAL LABORATORY Current Year CMS Clinical Lab Schedule - National Limit [* * *] New Technology: United acknowledges that Facility may develop and/or provide new technologies and/or new methodologies during the term of this Agreement. In addition, both parties acknowledge that there may be other circumstances in which there is no fee in the fee schedule, or where no relative value units have been established for a particular service. Facility shall notify United when such new technologies and/or methodologies are available, or no fee or relative value units have been established for a particular service and the parties shall develop the fee and/or relative value units associated with such new technologies and/or methodologies and/or services. The methodology for developing new fees or relative value units shall be as follows: (a) [* * *] (b) [* * *] UnitedHealthcare Facility Agreement Confidential and Proprietary UHC/FPA[ANC][State][Nat’l].08.07 0507 * Confidential Treatment Requested by Celera Corporation[***] indicates material that has been omitted pursuant to a request for confidential treatment. The omitted material has been filed separately with the Securities and Exchange Commission. (c) [* * *] (d) [* * *] (e) [* * *] Commercial [* * *] Medicare [* * *] UnitedHealthcare Facility Agreement Confidential and Proprietary UHC/FPA[ANC][Nat’l].08.07[State] 0807 * Confidential Treatment Requested by Celera Corporation*Proprietary