|
HC THERAPEUTIC ACTIVITY 15 MIN MCAL
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
901300061
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$212.40 |
| Rate for Payer: Adventist Health Commercial |
$47.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
|
|
HC THERAPEUTIC ACTIVITY 15MIN MCAL
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900400073
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$212.40 |
| Rate for Payer: Adventist Health Commercial |
$47.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
|
|
HC THERAPEUTIC ACTIVITY 15MIN MCAL
|
Facility
|
OP
|
$236.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900400073
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$96.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$145.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$129.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: Cigna of CA HMO |
$151.04
|
| Rate for Payer: Cigna of CA PPO |
$174.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$200.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$200.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$200.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$165.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
| Rate for Payer: Riverside University Health System MISP |
$94.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$200.60
|
| Rate for Payer: Vantage Medical Group Senior |
$200.60
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN OT
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905104224
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$212.40 |
| Rate for Payer: Adventist Health Commercial |
$47.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN OT
|
Facility
|
OP
|
$236.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905104224
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$96.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$145.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$129.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: Cigna of CA HMO |
$151.04
|
| Rate for Payer: Cigna of CA PPO |
$174.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$200.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$200.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$200.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$165.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
| Rate for Payer: Riverside University Health System MISP |
$94.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$200.60
|
| Rate for Payer: Vantage Medical Group Senior |
$200.60
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905103224
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$212.40 |
| Rate for Payer: Adventist Health Commercial |
$47.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT
|
Facility
|
OP
|
$236.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905103224
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$96.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$145.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$129.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: Cigna of CA HMO |
$151.04
|
| Rate for Payer: Cigna of CA PPO |
$174.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$200.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$200.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$200.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$165.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
| Rate for Payer: Riverside University Health System MISP |
$94.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$200.60
|
| Rate for Payer: Vantage Medical Group Senior |
$200.60
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT COMM MCARE
|
Facility
|
IP
|
$236.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900419055
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.20 |
| Max. Negotiated Rate |
$212.40 |
| Rate for Payer: Adventist Health Commercial |
$47.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT COMM MCARE
|
Facility
|
OP
|
$236.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900419055
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.16 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$96.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$145.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$129.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$177.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Cash Price |
$106.20
|
| Rate for Payer: Central Health Plan Commercial |
$188.80
|
| Rate for Payer: Cigna of CA HMO |
$151.04
|
| Rate for Payer: Cigna of CA PPO |
$174.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$200.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$200.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$200.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$165.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$94.40
|
| Rate for Payer: EPIC Health Plan Senior |
$94.40
|
| Rate for Payer: Galaxy Health WC |
$200.60
|
| Rate for Payer: Global Benefits Group Commercial |
$141.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$212.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$149.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$139.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.76
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$165.20
|
| Rate for Payer: Multiplan Commercial |
$177.00
|
| Rate for Payer: Networks By Design Commercial |
$153.40
|
| Rate for Payer: Prime Health Services Commercial |
$200.60
|
| Rate for Payer: Riverside University Health System MISP |
$94.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$141.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$141.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$200.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$200.60
|
| Rate for Payer: Vantage Medical Group Senior |
$200.60
|
|
|
HC THERAPEUTIC ASPIR BRONCH INITL
|
Facility
|
IP
|
$5,594.00
|
|
|
Service Code
|
CPT 31645
|
| Hospital Charge Code |
900803510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,118.80 |
| Max. Negotiated Rate |
$5,034.60 |
| Rate for Payer: Adventist Health Commercial |
$1,118.80
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,475.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,915.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,237.60
|
| Rate for Payer: EPIC Health Plan Senior |
$2,237.60
|
| Rate for Payer: Galaxy Health WC |
$4,754.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,356.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,034.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,552.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,300.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,118.80
|
| Rate for Payer: Multiplan Commercial |
$4,195.50
|
| Rate for Payer: Networks By Design Commercial |
$3,636.10
|
| Rate for Payer: Prime Health Services Commercial |
$4,754.90
|
|
|
HC THERAPEUTIC ASPIR BRONCH INITL
|
Facility
|
OP
|
$5,594.00
|
|
|
Service Code
|
CPT 31645
|
| Hospital Charge Code |
900803510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$256.14 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$1,118.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,289.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$878.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,289.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$3,546.60
|
| Rate for Payer: Blue Shield of California EPN |
$2,232.01
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Cash Price |
$2,517.30
|
| Rate for Payer: Central Health Plan Commercial |
$4,475.20
|
| Rate for Payer: Cigna of CA HMO |
$3,580.16
|
| Rate for Payer: Cigna of CA PPO |
$4,139.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,518.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,289.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,915.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,777.26
|
| Rate for Payer: EPIC Health Plan Senior |
$2,518.18
|
| Rate for Payer: Galaxy Health WC |
$4,754.90
|
| Rate for Payer: Global Benefits Group Commercial |
$3,356.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,034.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,754.37
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$256.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3,552.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$282.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3,204.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,118.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3,067.59
|
| Rate for Payer: Multiplan Commercial |
$4,195.50
|
| Rate for Payer: Networks By Design Commercial |
$3,636.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,289.25
|
| Rate for Payer: Prime Health Services Commercial |
$4,754.90
|
| Rate for Payer: Prime Health Services Medicare |
$2,426.61
|
| Rate for Payer: Riverside University Health System MISP |
$2,518.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,356.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,356.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,797.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,797.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,797.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,797.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,289.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,433.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,518.18
|
| Rate for Payer: Vantage Medical Group Senior |
$2,289.25
|
|
|
HC THERAPEUTIC INJECTION IA
|
Facility
|
IP
|
$618.00
|
|
|
Service Code
|
CPT 96373
|
| Hospital Charge Code |
909020041
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$123.60 |
| Max. Negotiated Rate |
$556.20 |
| Rate for Payer: Adventist Health Commercial |
$123.60
|
| Rate for Payer: Cash Price |
$278.10
|
| Rate for Payer: Central Health Plan Commercial |
$494.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$432.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$247.20
|
| Rate for Payer: EPIC Health Plan Senior |
$247.20
|
| Rate for Payer: Galaxy Health WC |
$525.30
|
| Rate for Payer: Global Benefits Group Commercial |
$370.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$556.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$392.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$364.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.60
|
| Rate for Payer: Multiplan Commercial |
$463.50
|
| Rate for Payer: Networks By Design Commercial |
$401.70
|
| Rate for Payer: Prime Health Services Commercial |
$525.30
|
|
|
HC THERAPEUTIC INJECTION IA
|
Facility
|
OP
|
$618.00
|
|
|
Service Code
|
CPT 96373
|
| Hospital Charge Code |
909020041
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$28.96 |
| Max. Negotiated Rate |
$1,029.00 |
| Rate for Payer: Adventist Health Commercial |
$123.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$273.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$410.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$300.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$273.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,029.00
|
| Rate for Payer: Cash Price |
$278.10
|
| Rate for Payer: Cash Price |
$278.10
|
| Rate for Payer: Cash Price |
$278.10
|
| Rate for Payer: Central Health Plan Commercial |
$494.40
|
| Rate for Payer: Cigna of CA HMO |
$395.52
|
| Rate for Payer: Cigna of CA PPO |
$457.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$410.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$300.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$273.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$432.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$451.39
|
| Rate for Payer: EPIC Health Plan Senior |
$300.93
|
| Rate for Payer: Galaxy Health WC |
$525.30
|
| Rate for Payer: Global Benefits Group Commercial |
$370.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$556.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$448.65
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$273.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$392.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$32.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$383.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$123.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$366.58
|
| Rate for Payer: Multiplan Commercial |
$463.50
|
| Rate for Payer: Networks By Design Commercial |
$401.70
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$273.57
|
| Rate for Payer: Prime Health Services Commercial |
$525.30
|
| Rate for Payer: Prime Health Services Medicare |
$289.98
|
| Rate for Payer: Riverside University Health System MISP |
$300.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$370.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$328.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$676.00
|
| Rate for Payer: United Healthcare All Other HMO |
$663.00
|
| Rate for Payer: United Healthcare HMO Rider |
$662.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$605.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$273.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$410.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$300.93
|
| Rate for Payer: Vantage Medical Group Senior |
$273.57
|
|
|
HC THERAPEUTIC PHLEBOTOMY
|
Facility
|
OP
|
$739.00
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
910100009
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$147.80 |
| Max. Negotiated Rate |
$5,523.00 |
| Rate for Payer: Adventist Health Commercial |
$147.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$171.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$557.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$171.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,523.00
|
| Rate for Payer: Blue Shield of California Commercial |
$468.53
|
| Rate for Payer: Blue Shield of California EPN |
$294.86
|
| Rate for Payer: Cash Price |
$332.55
|
| Rate for Payer: Cash Price |
$332.55
|
| Rate for Payer: Cash Price |
$332.55
|
| Rate for Payer: Cash Price |
$332.55
|
| Rate for Payer: Central Health Plan Commercial |
$591.20
|
| Rate for Payer: Cigna of CA HMO |
$472.96
|
| Rate for Payer: Cigna of CA PPO |
$546.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$256.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$188.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$171.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$517.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$282.35
|
| Rate for Payer: EPIC Health Plan Senior |
$188.23
|
| Rate for Payer: Galaxy Health WC |
$628.15
|
| Rate for Payer: Global Benefits Group Commercial |
$443.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$665.10
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$280.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$158.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$171.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$469.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$239.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$229.30
|
| Rate for Payer: Multiplan Commercial |
$554.25
|
| Rate for Payer: Networks By Design Commercial |
$480.35
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$171.12
|
| Rate for Payer: Prime Health Services Commercial |
$628.15
|
| Rate for Payer: Prime Health Services Medicare |
$181.39
|
| Rate for Payer: Riverside University Health System MISP |
$188.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$443.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$443.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$803.00
|
| Rate for Payer: United Healthcare All Other HMO |
$541.00
|
| Rate for Payer: United Healthcare HMO Rider |
$328.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$300.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$171.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$256.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$188.23
|
| Rate for Payer: Vantage Medical Group Senior |
$171.12
|
|
|
HC THERAPEUTIC PHLEBOTOMY
|
Facility
|
IP
|
$739.00
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
910100009
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$147.80 |
| Max. Negotiated Rate |
$665.10 |
| Rate for Payer: Adventist Health Commercial |
$147.80
|
| Rate for Payer: Cash Price |
$332.55
|
| Rate for Payer: Central Health Plan Commercial |
$591.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$517.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$295.60
|
| Rate for Payer: EPIC Health Plan Senior |
$295.60
|
| Rate for Payer: Galaxy Health WC |
$628.15
|
| Rate for Payer: Global Benefits Group Commercial |
$443.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$665.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$469.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$436.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$147.80
|
| Rate for Payer: Multiplan Commercial |
$554.25
|
| Rate for Payer: Networks By Design Commercial |
$480.35
|
| Rate for Payer: Prime Health Services Commercial |
$628.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN MCAL
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
907000036
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Cigna of CA HMO |
$154.24
|
| Rate for Payer: Cigna of CA PPO |
$178.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$204.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$204.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$168.70
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: Riverside University Health System MISP |
$96.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$204.85
|
| Rate for Payer: Vantage Medical Group Senior |
$204.85
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN MCAL
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
907000036
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.20
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN MCARE COMM
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
900407110
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.20
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN MCARE COMM
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
900407110
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Cigna of CA HMO |
$154.24
|
| Rate for Payer: Cigna of CA PPO |
$178.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$204.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$204.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$168.70
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: Riverside University Health System MISP |
$96.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$204.85
|
| Rate for Payer: Vantage Medical Group Senior |
$204.85
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN OT
|
Facility
|
OP
|
$108.00
|
|
| Hospital Charge Code |
901309044
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$44.28
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$91.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$59.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$81.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Central Health Plan Commercial |
$86.40
|
| Rate for Payer: Cigna of CA HMO |
$69.12
|
| Rate for Payer: Cigna of CA PPO |
$79.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$91.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$91.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$91.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$75.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Senior |
$43.20
|
| Rate for Payer: Galaxy Health WC |
$91.80
|
| Rate for Payer: Global Benefits Group Commercial |
$64.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$68.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$39.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$63.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$75.60
|
| Rate for Payer: Multiplan Commercial |
$81.00
|
| Rate for Payer: Networks By Design Commercial |
$70.20
|
| Rate for Payer: Prime Health Services Commercial |
$91.80
|
| Rate for Payer: Riverside University Health System MISP |
$43.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$91.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$91.80
|
| Rate for Payer: Vantage Medical Group Senior |
$91.80
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN OT
|
Facility
|
IP
|
$108.00
|
|
| Hospital Charge Code |
901309044
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$97.20 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Central Health Plan Commercial |
$86.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$75.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Senior |
$43.20
|
| Rate for Payer: Galaxy Health WC |
$91.80
|
| Rate for Payer: Global Benefits Group Commercial |
$64.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$68.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$63.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.60
|
| Rate for Payer: Multiplan Commercial |
$81.00
|
| Rate for Payer: Networks By Design Commercial |
$70.20
|
| Rate for Payer: Prime Health Services Commercial |
$91.80
|
|
|
HC THERAPEUTIC PROCEDURE 15MIN OT
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905104225
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.20
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
|
|
HC THERAPEUTIC PROCEDURE 15MIN OT
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905104225
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Cigna of CA HMO |
$154.24
|
| Rate for Payer: Cigna of CA PPO |
$178.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$204.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$204.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$168.70
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: Riverside University Health System MISP |
$96.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$204.85
|
| Rate for Payer: Vantage Medical Group Senior |
$204.85
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN PT
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905103225
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$48.20 |
| Max. Negotiated Rate |
$216.90 |
| Rate for Payer: Adventist Health Commercial |
$48.20
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$48.20
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN PT
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
900410478
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$132.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$180.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Cash Price |
$108.45
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| Rate for Payer: Cigna of CA HMO |
$154.24
|
| Rate for Payer: Cigna of CA PPO |
$178.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$204.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$204.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$168.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$96.40
|
| Rate for Payer: EPIC Health Plan Senior |
$96.40
|
| Rate for Payer: Galaxy Health WC |
$204.85
|
| Rate for Payer: Global Benefits Group Commercial |
$144.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$216.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$153.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$142.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$168.70
|
| Rate for Payer: Multiplan Commercial |
$180.75
|
| Rate for Payer: Networks By Design Commercial |
$156.65
|
| Rate for Payer: Prime Health Services Commercial |
$204.85
|
| Rate for Payer: Riverside University Health System MISP |
$96.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$144.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$144.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$204.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$204.85
|
| Rate for Payer: Vantage Medical Group Senior |
$204.85
|
|
