|
HC TEST/PHYSICAL PERF INITIAL 30MIN PT
|
Facility
IP
|
$158.00
|
|
|
Service Code
|
CPT 97690
|
| Hospital Charge Code |
903200167
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$31.60 |
| Max. Negotiated Rate |
$142.20 |
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Central Health Plan Commercial |
$126.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.20
|
| Rate for Payer: Galaxy Health WC |
$134.30
|
| Rate for Payer: Global Benefits Group Commercial |
$94.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$142.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$105.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.60
|
| Rate for Payer: Multiplan Commercial |
$118.50
|
| Rate for Payer: Networks By Design Commercial |
$102.70
|
| Rate for Payer: Prime Health Services Commercial |
$134.30
|
|
|
HC TEST/PHYSICAL PERF INITIAL 30MIN PT
|
Facility
OP
|
$158.00
|
|
|
Service Code
|
CPT 97690
|
| Hospital Charge Code |
903200167
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$55.30 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$95.95
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$134.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$86.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$86.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$94.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Cash Price |
$71.10
|
| Rate for Payer: Central Health Plan Commercial |
$126.40
|
| Rate for Payer: Cigna of CA HMO |
$101.12
|
| Rate for Payer: Cigna of CA PPO |
$116.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$134.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$63.20
|
| Rate for Payer: Galaxy Health WC |
$134.30
|
| Rate for Payer: Global Benefits Group Commercial |
$94.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$142.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$118.50
|
| Rate for Payer: IEHP medi-cal |
$55.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$105.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$64.78
|
| Rate for Payer: Multiplan Commercial |
$118.50
|
| Rate for Payer: Networks By Design Commercial |
$102.70
|
| Rate for Payer: Prime Health Services Commercial |
$134.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$94.80
|
| Rate for Payer: Riverside University Health MISP |
$63.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$94.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$94.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$134.30
|
| Rate for Payer: Vantage Medical Group Senior |
$134.30
|
|
|
HC TEST URINE VOLUME
|
Facility
IP
|
$89.00
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
900910797
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$17.80 |
| Max. Negotiated Rate |
$80.10 |
| Rate for Payer: Cash Price |
$40.05
|
| Rate for Payer: Central Health Plan Commercial |
$71.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$35.60
|
| Rate for Payer: Galaxy Health WC |
$75.65
|
| Rate for Payer: Global Benefits Group Commercial |
$53.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$80.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$59.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$17.80
|
| Rate for Payer: Multiplan Commercial |
$66.75
|
| Rate for Payer: Networks By Design Commercial |
$57.85
|
| Rate for Payer: Prime Health Services Commercial |
$75.65
|
|
|
HC TEST URINE VOLUME
|
Facility
OP
|
$11.00
|
|
|
Service Code
|
CPT 81050
|
| Hospital Charge Code |
900910797
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$22.58 |
| Rate for Payer: Adventist Health Medi-Cal |
$3.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.03
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.58
|
| Rate for Payer: BCBS Transplant Transplant |
$6.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6.80
|
| Rate for Payer: Blue Shield of California EPN |
$5.35
|
| Rate for Payer: Caremore Medicare Advantage |
$3.64
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Central Health Plan Commercial |
$8.80
|
| Rate for Payer: Cigna of CA HMO |
$7.04
|
| Rate for Payer: Cigna of CA PPO |
$8.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.91
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.64
|
| Rate for Payer: Galaxy Health WC |
$9.35
|
| Rate for Payer: Global Benefits Group Commercial |
$6.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$5.97
|
| Rate for Payer: IEHP medi-cal |
$6.01
|
| Rate for Payer: IEHP Medicare Advantage |
$3.64
|
| Rate for Payer: Innovage PACE Commercial |
$5.46
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.88
|
| Rate for Payer: Multiplan Commercial |
$8.25
|
| Rate for Payer: Networks By Design Commercial |
$7.15
|
| Rate for Payer: Prime Health Services Commercial |
$9.35
|
| Rate for Payer: Prime Health Services Medicare |
$3.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.60
|
| Rate for Payer: Riverside University Health MISP |
$4.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.95
|
| Rate for Payer: United Healthcare All Other HMO |
$2.95
|
| Rate for Payer: United Healthcare HMO Rider |
$2.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.00
|
| Rate for Payer: Vantage Medical Group Senior |
$3.64
|
|
|
HC TETRACYCLINE E TEST
|
Facility
OP
|
$11.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912444
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.20 |
| Max. Negotiated Rate |
$20.01 |
| Rate for Payer: Adventist Health Medi-Cal |
$4.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.01
|
| Rate for Payer: BCBS Transplant Transplant |
$6.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6.80
|
| Rate for Payer: Blue Shield of California EPN |
$5.35
|
| Rate for Payer: Caremore Medicare Advantage |
$4.75
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Cash Price |
$4.95
|
| Rate for Payer: Central Health Plan Commercial |
$8.80
|
| Rate for Payer: Cigna of CA HMO |
$7.04
|
| Rate for Payer: Cigna of CA PPO |
$8.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.41
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$4.75
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.75
|
| Rate for Payer: Galaxy Health WC |
$9.35
|
| Rate for Payer: Global Benefits Group Commercial |
$6.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.79
|
| Rate for Payer: IEHP medi-cal |
$7.84
|
| Rate for Payer: IEHP Medicare Advantage |
$4.75
|
| Rate for Payer: Innovage PACE Commercial |
$7.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.36
|
| Rate for Payer: Multiplan Commercial |
$8.25
|
| Rate for Payer: Networks By Design Commercial |
$7.15
|
| Rate for Payer: Prime Health Services Commercial |
$9.35
|
| Rate for Payer: Prime Health Services Medicare |
$5.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.60
|
| Rate for Payer: Riverside University Health MISP |
$5.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.85
|
| Rate for Payer: United Healthcare All Other HMO |
$3.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.22
|
| Rate for Payer: Vantage Medical Group Senior |
$4.75
|
|
|
HC TETRACYCLINE E TEST
|
Facility
IP
|
$108.00
|
|
|
Service Code
|
CPT 87181
|
| Hospital Charge Code |
900912444
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$97.20 |
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Central Health Plan Commercial |
$86.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$72.04
|
| 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 THAKO PARAPODIUM
|
Facility
OP
|
$6,911.00
|
|
|
Service Code
|
CPT L1500
|
| Hospital Charge Code |
905351500
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,418.85 |
| Max. Negotiated Rate |
$6,219.90 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,874.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,801.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,801.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,346.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,083.02
|
| Rate for Payer: BCBS Transplant Transplant |
$4,146.60
|
| Rate for Payer: Blue Shield of California Commercial |
$5,183.25
|
| Rate for Payer: Blue Shield of California EPN |
$3,759.58
|
| Rate for Payer: Cash Price |
$3,109.95
|
| Rate for Payer: Cash Price |
$3,109.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,528.80
|
| Rate for Payer: Cigna of CA HMO |
$4,837.70
|
| Rate for Payer: Cigna of CA PPO |
$4,837.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,874.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,764.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,764.40
|
| Rate for Payer: Galaxy Health WC |
$5,874.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,146.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,219.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,183.25
|
| Rate for Payer: IEHP medi-cal |
$2,418.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,609.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,833.51
|
| Rate for Payer: Multiplan Commercial |
$5,183.25
|
| Rate for Payer: Networks By Design Commercial |
$3,455.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,874.35
|
| Rate for Payer: Riverside University Health MISP |
$2,764.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,146.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4,146.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,455.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3,455.50
|
| Rate for Payer: United Healthcare HMO Rider |
$3,455.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,455.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5,874.35
|
| Rate for Payer: Vantage Medical Group Senior |
$5,874.35
|
|
|
HC THAKO PARAPODIUM
|
Facility
IP
|
$6,911.00
|
|
|
Service Code
|
CPT L1500
|
| Hospital Charge Code |
905351500
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,382.20 |
| Max. Negotiated Rate |
$6,219.90 |
| Rate for Payer: Blue Shield of California EPN |
$3,690.47
|
| Rate for Payer: Cash Price |
$3,109.95
|
| Rate for Payer: Central Health Plan Commercial |
$5,528.80
|
| Rate for Payer: Cigna of CA HMO |
$4,837.70
|
| Rate for Payer: Cigna of CA PPO |
$4,837.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,764.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,764.40
|
| Rate for Payer: Galaxy Health WC |
$5,874.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4,146.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,219.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,609.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,382.20
|
| Rate for Payer: Multiplan Commercial |
$5,183.25
|
| Rate for Payer: Networks By Design Commercial |
$3,455.50
|
| Rate for Payer: Prime Health Services Commercial |
$5,874.35
|
|
|
HC THAKO STANDING FRAME
|
Facility
OP
|
$3,546.00
|
|
|
Service Code
|
CPT L1510
|
| Hospital Charge Code |
905351510
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$1,241.10 |
| Max. Negotiated Rate |
$3,191.40 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,014.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1,950.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1,950.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,716.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,094.98
|
| Rate for Payer: BCBS Transplant Transplant |
$2,127.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2,659.50
|
| Rate for Payer: Blue Shield of California EPN |
$1,929.02
|
| Rate for Payer: Cash Price |
$1,595.70
|
| Rate for Payer: Cash Price |
$1,595.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,836.80
|
| Rate for Payer: Cigna of CA HMO |
$2,482.20
|
| Rate for Payer: Cigna of CA PPO |
$2,482.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,014.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,418.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,418.40
|
| Rate for Payer: Galaxy Health WC |
$3,014.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,127.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,191.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2,659.50
|
| Rate for Payer: IEHP medi-cal |
$1,241.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,365.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,453.86
|
| Rate for Payer: Multiplan Commercial |
$2,659.50
|
| Rate for Payer: Networks By Design Commercial |
$1,773.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,014.10
|
| Rate for Payer: Riverside University Health MISP |
$1,418.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,127.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,127.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,773.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,773.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,773.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,773.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,014.10
|
| Rate for Payer: Vantage Medical Group Senior |
$3,014.10
|
|
|
HC THAKO STANDING FRAME
|
Facility
IP
|
$3,546.00
|
|
|
Service Code
|
CPT L1510
|
| Hospital Charge Code |
905351510
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$709.20 |
| Max. Negotiated Rate |
$3,191.40 |
| Rate for Payer: Blue Shield of California EPN |
$1,893.56
|
| Rate for Payer: Cash Price |
$1,595.70
|
| Rate for Payer: Central Health Plan Commercial |
$2,836.80
|
| Rate for Payer: Cigna of CA HMO |
$2,482.20
|
| Rate for Payer: Cigna of CA PPO |
$2,482.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,418.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,418.40
|
| Rate for Payer: Galaxy Health WC |
$3,014.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2,127.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$3,191.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2,365.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$709.20
|
| Rate for Payer: Multiplan Commercial |
$2,659.50
|
| Rate for Payer: Networks By Design Commercial |
$1,773.00
|
| Rate for Payer: Prime Health Services Commercial |
$3,014.10
|
|
|
HC THAKO SWIVEL WALKER
|
Facility
IP
|
$11,058.00
|
|
|
Service Code
|
CPT L1520
|
| Hospital Charge Code |
905351520
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$2,211.60 |
| Max. Negotiated Rate |
$9,952.20 |
| Rate for Payer: Blue Shield of California EPN |
$5,904.97
|
| Rate for Payer: Cash Price |
$4,976.10
|
| Rate for Payer: Central Health Plan Commercial |
$8,846.40
|
| Rate for Payer: Cigna of CA HMO |
$7,740.60
|
| Rate for Payer: Cigna of CA PPO |
$7,740.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,423.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,423.20
|
| Rate for Payer: Galaxy Health WC |
$9,399.30
|
| Rate for Payer: Global Benefits Group Commercial |
$6,634.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,952.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,375.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,211.60
|
| Rate for Payer: Multiplan Commercial |
$8,293.50
|
| Rate for Payer: Networks By Design Commercial |
$5,529.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,399.30
|
|
|
HC THAKO SWIVEL WALKER
|
Facility
OP
|
$11,058.00
|
|
|
Service Code
|
CPT L1520
|
| Hospital Charge Code |
905351520
|
|
Hospital Revenue Code
|
274
|
| Min. Negotiated Rate |
$3,870.30 |
| Max. Negotiated Rate |
$9,952.20 |
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9,399.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6,081.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6,081.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,354.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,533.07
|
| Rate for Payer: BCBS Transplant Transplant |
$6,634.80
|
| Rate for Payer: Blue Shield of California Commercial |
$8,293.50
|
| Rate for Payer: Blue Shield of California EPN |
$6,015.55
|
| Rate for Payer: Cash Price |
$4,976.10
|
| Rate for Payer: Cash Price |
$4,976.10
|
| Rate for Payer: Central Health Plan Commercial |
$8,846.40
|
| Rate for Payer: Cigna of CA HMO |
$7,740.60
|
| Rate for Payer: Cigna of CA PPO |
$7,740.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,399.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,423.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$4,423.20
|
| Rate for Payer: Galaxy Health WC |
$9,399.30
|
| Rate for Payer: Global Benefits Group Commercial |
$6,634.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,952.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8,293.50
|
| Rate for Payer: IEHP medi-cal |
$3,870.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7,375.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,533.78
|
| Rate for Payer: Multiplan Commercial |
$8,293.50
|
| Rate for Payer: Networks By Design Commercial |
$5,529.00
|
| Rate for Payer: Prime Health Services Commercial |
$9,399.30
|
| Rate for Payer: Riverside University Health MISP |
$4,423.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,634.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6,634.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,529.00
|
| Rate for Payer: United Healthcare All Other HMO |
$5,529.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,529.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,529.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9,399.30
|
| Rate for Payer: Vantage Medical Group Senior |
$9,399.30
|
|
|
HC THAL-QUICK 18FR CHEST TUBE
|
Facility
OP
|
$889.13
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698529
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$177.83 |
| Max. Negotiated Rate |
$800.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$312.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$755.76
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$489.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$489.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$405.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$495.25
|
| Rate for Payer: BCBS Transplant Transplant |
$533.48
|
| Rate for Payer: Blue Shield of California Commercial |
$666.85
|
| Rate for Payer: Blue Shield of California EPN |
$483.69
|
| Rate for Payer: Cash Price |
$400.11
|
| Rate for Payer: Cash Price |
$400.11
|
| Rate for Payer: Central Health Plan Commercial |
$711.30
|
| Rate for Payer: Cigna of CA HMO |
$622.39
|
| Rate for Payer: Cigna of CA PPO |
$622.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$755.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.65
|
| Rate for Payer: EPIC Health Plan Transplant |
$355.65
|
| Rate for Payer: Galaxy Health WC |
$755.76
|
| Rate for Payer: Global Benefits Group Commercial |
$533.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$800.22
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$666.85
|
| Rate for Payer: IEHP medi-cal |
$311.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.83
|
| Rate for Payer: Multiplan Commercial |
$666.85
|
| Rate for Payer: Networks By Design Commercial |
$444.56
|
| Rate for Payer: Prime Health Services Commercial |
$755.76
|
| Rate for Payer: Riverside University Health MISP |
$355.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$533.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$533.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$444.56
|
| Rate for Payer: United Healthcare All Other HMO |
$444.56
|
| Rate for Payer: United Healthcare HMO Rider |
$444.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$444.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$755.76
|
| Rate for Payer: Vantage Medical Group Senior |
$755.76
|
|
|
HC THAL-QUICK 18FR CHEST TUBE
|
Facility
IP
|
$889.13
|
|
|
Service Code
|
CPT C1729
|
| Hospital Charge Code |
901698529
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$177.83 |
| Max. Negotiated Rate |
$800.22 |
| Rate for Payer: Blue Shield of California EPN |
$474.80
|
| Rate for Payer: Cash Price |
$400.11
|
| Rate for Payer: Central Health Plan Commercial |
$711.30
|
| Rate for Payer: Cigna of CA HMO |
$622.39
|
| Rate for Payer: Cigna of CA PPO |
$622.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$355.65
|
| Rate for Payer: EPIC Health Plan Transplant |
$355.65
|
| Rate for Payer: Galaxy Health WC |
$755.76
|
| Rate for Payer: Global Benefits Group Commercial |
$533.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$800.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$593.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$177.83
|
| Rate for Payer: Multiplan Commercial |
$666.85
|
| Rate for Payer: Prime Health Services Commercial |
$755.76
|
|
|
HC THEOPHYLLINE
|
Facility
OP
|
$50.00
|
|
|
Service Code
|
CPT 80198
|
| Hospital Charge Code |
900910457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$125.57 |
| Rate for Payer: Adventist Health Medi-Cal |
$14.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$103.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$102.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$125.57
|
| Rate for Payer: BCBS Transplant Transplant |
$30.00
|
| Rate for Payer: Blue Shield of California Commercial |
$30.90
|
| Rate for Payer: Blue Shield of California EPN |
$24.30
|
| Rate for Payer: Caremore Medicare Advantage |
$14.14
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Cash Price |
$22.50
|
| Rate for Payer: Central Health Plan Commercial |
$40.00
|
| Rate for Payer: Cigna of CA HMO |
$32.00
|
| Rate for Payer: Cigna of CA PPO |
$37.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.09
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$14.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.14
|
| Rate for Payer: Galaxy Health WC |
$42.50
|
| Rate for Payer: Global Benefits Group Commercial |
$30.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$23.19
|
| Rate for Payer: IEHP medi-cal |
$23.33
|
| Rate for Payer: IEHP Medicare Advantage |
$14.14
|
| Rate for Payer: Innovage PACE Commercial |
$21.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.95
|
| Rate for Payer: Multiplan Commercial |
$37.50
|
| Rate for Payer: Networks By Design Commercial |
$32.50
|
| Rate for Payer: Prime Health Services Commercial |
$42.50
|
| Rate for Payer: Prime Health Services Medicare |
$14.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: Riverside University Health MISP |
$15.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.46
|
| Rate for Payer: United Healthcare All Other HMO |
$11.46
|
| Rate for Payer: United Healthcare HMO Rider |
$11.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.55
|
| Rate for Payer: Vantage Medical Group Senior |
$14.14
|
|
|
HC THEOPHYLLINE
|
Facility
IP
|
$204.00
|
|
|
Service Code
|
CPT 80198
|
| Hospital Charge Code |
900910457
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$40.80 |
| Max. Negotiated Rate |
$183.60 |
| Rate for Payer: Cash Price |
$91.80
|
| Rate for Payer: Central Health Plan Commercial |
$163.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$81.60
|
| Rate for Payer: Galaxy Health WC |
$173.40
|
| Rate for Payer: Global Benefits Group Commercial |
$122.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$183.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$136.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.80
|
| Rate for Payer: Multiplan Commercial |
$153.00
|
| Rate for Payer: Networks By Design Commercial |
$132.60
|
| Rate for Payer: Prime Health Services Commercial |
$173.40
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN MCAL
|
Facility
IP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
901300061
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$58.60 |
| Max. Negotiated Rate |
$263.70 |
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.60
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN MCAL
|
Facility
OP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
901300061
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$102.55 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$134.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$161.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$175.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$117.20
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$219.75
|
| Rate for Payer: IEHP medi-cal |
$102.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.13
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: Riverside University Health MISP |
$117.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
|
|
HC THERAPEUTIC ACTIVITY 15MIN MCAL
|
Facility
IP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900400073
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$58.60 |
| Max. Negotiated Rate |
$263.70 |
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.60
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
|
|
HC THERAPEUTIC ACTIVITY 15MIN MCAL
|
Facility
OP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900400073
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$102.55 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$134.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$161.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$175.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$117.20
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$219.75
|
| Rate for Payer: IEHP medi-cal |
$102.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.13
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: Riverside University Health MISP |
$117.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN OT
|
Facility
IP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905104224
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$58.60 |
| Max. Negotiated Rate |
$263.70 |
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.60
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN OT
|
Facility
OP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905104224
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$102.55 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$134.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$161.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$175.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$117.20
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$219.75
|
| Rate for Payer: IEHP medi-cal |
$102.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.13
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: Riverside University Health MISP |
$117.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT
|
Facility
IP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905103224
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$58.60 |
| Max. Negotiated Rate |
$263.70 |
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.60
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT
|
Facility
OP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
905103224
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$102.55 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$134.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$161.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$175.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$117.20
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$219.75
|
| Rate for Payer: IEHP medi-cal |
$102.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.13
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: Riverside University Health MISP |
$117.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
|
|
HC THERAPEUTIC ACTIVITY 15 MIN PT COMM MCARE
|
Facility
OP
|
$293.00
|
|
|
Service Code
|
CPT 97530
|
| Hospital Charge Code |
900419055
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$102.55 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$134.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$249.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$161.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$161.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: BCBS Transplant Transplant |
$175.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Cash Price |
$131.85
|
| Rate for Payer: Central Health Plan Commercial |
$234.40
|
| Rate for Payer: Cigna of CA HMO |
$187.52
|
| Rate for Payer: Cigna of CA PPO |
$216.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$249.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$117.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$117.20
|
| Rate for Payer: Galaxy Health WC |
$249.05
|
| Rate for Payer: Global Benefits Group Commercial |
$175.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$263.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$219.75
|
| Rate for Payer: IEHP medi-cal |
$102.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$195.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.13
|
| Rate for Payer: Multiplan Commercial |
$219.75
|
| Rate for Payer: Networks By Design Commercial |
$190.45
|
| Rate for Payer: Prime Health Services Commercial |
$249.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: Riverside University Health MISP |
$117.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$175.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$175.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$249.05
|
| Rate for Payer: Vantage Medical Group Senior |
$249.05
|
|
