|
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
|
|
|
HC THERAPEUTIC ASPIR BRONCH INITL
|
Facility
IP
|
$4,750.00
|
|
|
Service Code
|
CPT 31645
|
| Hospital Charge Code |
900803510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$950.00 |
| Max. Negotiated Rate |
$4,275.00 |
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,800.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,900.00
|
| Rate for Payer: Galaxy Health WC |
$4,037.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,850.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,275.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,168.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.00
|
| Rate for Payer: Multiplan Commercial |
$3,562.50
|
| Rate for Payer: Networks By Design Commercial |
$3,087.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,037.50
|
|
|
HC THERAPEUTIC ASPIR BRONCH INITL
|
Facility
OP
|
$4,750.00
|
|
|
Service Code
|
CPT 31645
|
| Hospital Charge Code |
900803510
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$950.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$2,850.00
|
| Rate for Payer: Blue Shield of California Commercial |
$2,987.75
|
| Rate for Payer: Blue Shield of California EPN |
$2,322.75
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Cash Price |
$2,137.50
|
| Rate for Payer: Central Health Plan Commercial |
$3,800.00
|
| Rate for Payer: Cigna of CA HMO |
$3,040.00
|
| Rate for Payer: Cigna of CA PPO |
$3,515.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Galaxy Health WC |
$4,037.50
|
| Rate for Payer: Global Benefits Group Commercial |
$2,850.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,275.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3,562.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: IEHP medi-cal |
$3,499.02
|
| Rate for Payer: IEHP Medicare Advantage |
$2,120.62
|
| Rate for Payer: Innovage PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,168.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$950.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Multiplan Commercial |
$3,562.50
|
| Rate for Payer: Networks By Design Commercial |
$3,087.50
|
| Rate for Payer: Prime Health Services Commercial |
$4,037.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2,850.00
|
| Rate for Payer: Riverside University Health MISP |
$2,332.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,850.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,850.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$2,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$2,375.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2,375.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2,375.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
HC THERAPEUTIC INJECTION IA
|
Facility
IP
|
$659.00
|
|
|
Service Code
|
CPT 96373
|
| Hospital Charge Code |
909020041
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$131.80 |
| Max. Negotiated Rate |
$593.10 |
| Rate for Payer: Cash Price |
$296.55
|
| Rate for Payer: Central Health Plan Commercial |
$527.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$263.60
|
| Rate for Payer: Galaxy Health WC |
$560.15
|
| Rate for Payer: Global Benefits Group Commercial |
$395.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$593.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$439.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.80
|
| Rate for Payer: Multiplan Commercial |
$494.25
|
| Rate for Payer: Networks By Design Commercial |
$428.35
|
| Rate for Payer: Prime Health Services Commercial |
$560.15
|
|
|
HC THERAPEUTIC INJECTION IA
|
Facility
OP
|
$659.00
|
|
|
Service Code
|
CPT 96373
|
| Hospital Charge Code |
909020041
|
|
Hospital Revenue Code
|
260
|
| Min. Negotiated Rate |
$112.71 |
| Max. Negotiated Rate |
$903.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$267.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$112.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$267.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$742.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$903.00
|
| Rate for Payer: BCBS Transplant Transplant |
$395.40
|
| Rate for Payer: Caremore Medicare Advantage |
$267.80
|
| Rate for Payer: Cash Price |
$296.55
|
| Rate for Payer: Cash Price |
$296.55
|
| Rate for Payer: Cash Price |
$296.55
|
| Rate for Payer: Central Health Plan Commercial |
$527.20
|
| Rate for Payer: Cigna of CA HMO |
$421.76
|
| Rate for Payer: Cigna of CA PPO |
$487.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$401.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$361.53
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$267.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$267.80
|
| Rate for Payer: Galaxy Health WC |
$560.15
|
| Rate for Payer: Global Benefits Group Commercial |
$395.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$593.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$494.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$439.19
|
| Rate for Payer: IEHP medi-cal |
$441.87
|
| Rate for Payer: IEHP Medicare Advantage |
$267.80
|
| Rate for Payer: Innovage PACE Commercial |
$401.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$439.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$267.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$131.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$358.85
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$358.85
|
| Rate for Payer: Multiplan Commercial |
$494.25
|
| Rate for Payer: Networks By Design Commercial |
$428.35
|
| Rate for Payer: Prime Health Services Commercial |
$560.15
|
| Rate for Payer: Prime Health Services Medicare |
$283.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$294.58
|
| Rate for Payer: Riverside University Health MISP |
$294.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$395.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$321.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$642.00
|
| Rate for Payer: United Healthcare All Other HMO |
$631.00
|
| Rate for Payer: United Healthcare HMO Rider |
$630.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$575.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$401.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$294.58
|
| Rate for Payer: Vantage Medical Group Senior |
$267.80
|
|
|
HC THERAPEUTIC PHLEBOTOMY
|
Facility
OP
|
$559.00
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
910100009
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$111.80 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$159.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$520.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$159.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: BCBS Transplant Transplant |
$335.40
|
| Rate for Payer: Blue Shield of California Commercial |
$351.61
|
| Rate for Payer: Blue Shield of California EPN |
$273.35
|
| Rate for Payer: Caremore Medicare Advantage |
$159.60
|
| Rate for Payer: Cash Price |
$251.55
|
| Rate for Payer: Cash Price |
$251.55
|
| Rate for Payer: Cash Price |
$251.55
|
| Rate for Payer: Central Health Plan Commercial |
$447.20
|
| Rate for Payer: Cigna of CA HMO |
$357.76
|
| Rate for Payer: Cigna of CA PPO |
$413.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$239.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.46
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$159.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$159.60
|
| Rate for Payer: Galaxy Health WC |
$475.15
|
| Rate for Payer: Global Benefits Group Commercial |
$335.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$503.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$419.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$261.74
|
| Rate for Payer: IEHP medi-cal |
$263.34
|
| Rate for Payer: IEHP Medicare Advantage |
$159.60
|
| Rate for Payer: Innovage PACE Commercial |
$239.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$372.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$159.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$213.86
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$213.86
|
| Rate for Payer: Multiplan Commercial |
$419.25
|
| Rate for Payer: Networks By Design Commercial |
$363.35
|
| Rate for Payer: Prime Health Services Commercial |
$475.15
|
| Rate for Payer: Prime Health Services Medicare |
$169.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$335.40
|
| Rate for Payer: Riverside University Health MISP |
$175.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$335.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$335.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$762.00
|
| Rate for Payer: United Healthcare All Other HMO |
$515.00
|
| Rate for Payer: United Healthcare HMO Rider |
$312.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$285.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$239.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$175.56
|
| Rate for Payer: Vantage Medical Group Senior |
$159.60
|
|
|
HC THERAPEUTIC PHLEBOTOMY
|
Facility
IP
|
$559.00
|
|
|
Service Code
|
CPT 99195
|
| Hospital Charge Code |
910100009
|
|
Hospital Revenue Code
|
940
|
| Min. Negotiated Rate |
$111.80 |
| Max. Negotiated Rate |
$503.10 |
| Rate for Payer: Cash Price |
$251.55
|
| Rate for Payer: Central Health Plan Commercial |
$447.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$223.60
|
| Rate for Payer: Galaxy Health WC |
$475.15
|
| Rate for Payer: Global Benefits Group Commercial |
$335.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$503.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$372.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$111.80
|
| Rate for Payer: Multiplan Commercial |
$419.25
|
| Rate for Payer: Networks By Design Commercial |
$363.35
|
| Rate for Payer: Prime Health Services Commercial |
$475.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN MCAL
|
Facility
OP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
907000036
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$104.65 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$254.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$164.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$164.45
|
| 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 |
$179.40
|
| 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 |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: Cigna of CA HMO |
$191.36
|
| Rate for Payer: Cigna of CA PPO |
$221.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$254.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$224.25
|
| Rate for Payer: IEHP medi-cal |
$104.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.59
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$179.40
|
| Rate for Payer: Riverside University Health MISP |
$119.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$179.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$179.40
|
| 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 |
$254.15
|
| Rate for Payer: Vantage Medical Group Senior |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN MCAL
|
Facility
IP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
907000036
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$59.80 |
| Max. Negotiated Rate |
$269.10 |
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.80
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN MCARE COMM
|
Facility
OP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
900407110
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$104.65 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$254.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$164.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$164.45
|
| 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 |
$179.40
|
| 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 |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: Cigna of CA HMO |
$191.36
|
| Rate for Payer: Cigna of CA PPO |
$221.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$254.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$224.25
|
| Rate for Payer: IEHP medi-cal |
$104.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.59
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$179.40
|
| Rate for Payer: Riverside University Health MISP |
$119.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$179.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$179.40
|
| 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 |
$254.15
|
| Rate for Payer: Vantage Medical Group Senior |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN MCARE COMM
|
Facility
IP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
900407110
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.80 |
| Max. Negotiated Rate |
$269.10 |
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.80
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN OT
|
Facility
OP
|
$102.00
|
|
| Hospital Charge Code |
901309044
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$35.70 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$61.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$86.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$56.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$56.10
|
| 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 |
$61.20
|
| 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 |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Central Health Plan Commercial |
$81.60
|
| Rate for Payer: Cigna of CA HMO |
$65.28
|
| Rate for Payer: Cigna of CA PPO |
$75.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$40.80
|
| Rate for Payer: Galaxy Health WC |
$86.70
|
| Rate for Payer: Global Benefits Group Commercial |
$61.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$76.50
|
| Rate for Payer: IEHP medi-cal |
$35.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$41.82
|
| Rate for Payer: Multiplan Commercial |
$76.50
|
| Rate for Payer: Networks By Design Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Commercial |
$86.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$61.20
|
| Rate for Payer: Riverside University Health MISP |
$40.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.20
|
| 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 |
$86.70
|
| Rate for Payer: Vantage Medical Group Senior |
$86.70
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN OT
|
Facility
IP
|
$102.00
|
|
| Hospital Charge Code |
901309044
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$20.40 |
| Max. Negotiated Rate |
$91.80 |
| Rate for Payer: Cash Price |
$45.90
|
| Rate for Payer: Central Health Plan Commercial |
$81.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.80
|
| Rate for Payer: Galaxy Health WC |
$86.70
|
| Rate for Payer: Global Benefits Group Commercial |
$61.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$91.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$68.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.40
|
| Rate for Payer: Multiplan Commercial |
$76.50
|
| Rate for Payer: Networks By Design Commercial |
$66.30
|
| Rate for Payer: Prime Health Services Commercial |
$86.70
|
|
|
HC THERAPEUTIC PROCEDURE 15MIN OT
|
Facility
IP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905104225
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$59.80 |
| Max. Negotiated Rate |
$269.10 |
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.80
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15MIN OT
|
Facility
OP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905104225
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$104.65 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$254.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$164.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$164.45
|
| 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 |
$179.40
|
| 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 |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: Cigna of CA HMO |
$191.36
|
| Rate for Payer: Cigna of CA PPO |
$221.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$254.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$224.25
|
| Rate for Payer: IEHP medi-cal |
$104.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.59
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$179.40
|
| Rate for Payer: Riverside University Health MISP |
$119.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$179.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$179.40
|
| 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 |
$254.15
|
| Rate for Payer: Vantage Medical Group Senior |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN PT
|
Facility
OP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905103225
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$104.65 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$254.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$164.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$164.45
|
| 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 |
$179.40
|
| 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 |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: Cigna of CA HMO |
$191.36
|
| Rate for Payer: Cigna of CA PPO |
$221.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$254.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$224.25
|
| Rate for Payer: IEHP medi-cal |
$104.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.59
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$179.40
|
| Rate for Payer: Riverside University Health MISP |
$119.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$179.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$179.40
|
| 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 |
$254.15
|
| Rate for Payer: Vantage Medical Group Senior |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN PT
|
Facility
IP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
900410478
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.80 |
| Max. Negotiated Rate |
$269.10 |
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.80
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN PT
|
Facility
OP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
900410478
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$104.65 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$254.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$164.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$164.45
|
| 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 |
$179.40
|
| 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 |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: Cigna of CA HMO |
$191.36
|
| Rate for Payer: Cigna of CA PPO |
$221.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$254.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$224.25
|
| Rate for Payer: IEHP medi-cal |
$104.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.59
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$179.40
|
| Rate for Payer: Riverside University Health MISP |
$119.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$179.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$179.40
|
| 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 |
$254.15
|
| Rate for Payer: Vantage Medical Group Senior |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN PT
|
Facility
IP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905103225
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.80 |
| Max. Negotiated Rate |
$269.10 |
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.80
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN ST
|
Facility
OP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905601304
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$104.65 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$254.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$164.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$164.45
|
| 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 |
$179.40
|
| 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 |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: Cigna of CA HMO |
$191.36
|
| Rate for Payer: Cigna of CA PPO |
$221.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$254.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$224.25
|
| Rate for Payer: IEHP medi-cal |
$104.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.59
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$179.40
|
| Rate for Payer: Riverside University Health MISP |
$119.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$179.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$179.40
|
| 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 |
$254.15
|
| Rate for Payer: Vantage Medical Group Senior |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 15 MIN ST
|
Facility
IP
|
$299.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905601304
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$59.80 |
| Max. Negotiated Rate |
$269.10 |
| Rate for Payer: Cash Price |
$134.55
|
| Rate for Payer: Central Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$119.60
|
| Rate for Payer: Galaxy Health WC |
$254.15
|
| Rate for Payer: Global Benefits Group Commercial |
$179.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$269.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$199.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.80
|
| Rate for Payer: Multiplan Commercial |
$224.25
|
| Rate for Payer: Networks By Design Commercial |
$194.35
|
| Rate for Payer: Prime Health Services Commercial |
$254.15
|
|
|
HC THERAPEUTIC PROCEDURE 30MIN MCAL
|
Facility
OP
|
$170.00
|
|
| Hospital Charge Code |
900409030
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$59.50 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$103.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$144.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$93.50
|
| 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 |
$102.00
|
| 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 |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: Cigna of CA HMO |
$108.80
|
| Rate for Payer: Cigna of CA PPO |
$125.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$144.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$127.50
|
| Rate for Payer: IEHP medi-cal |
$59.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.70
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$102.00
|
| Rate for Payer: Riverside University Health MISP |
$68.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$102.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$102.00
|
| 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 |
$144.50
|
| Rate for Payer: Vantage Medical Group Senior |
$144.50
|
|
|
HC THERAPEUTIC PROCEDURE 30MIN MCAL
|
Facility
IP
|
$170.00
|
|
| Hospital Charge Code |
900409030
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$34.00 |
| Max. Negotiated Rate |
$153.00 |
| Rate for Payer: Cash Price |
$76.50
|
| Rate for Payer: Central Health Plan Commercial |
$136.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.00
|
| Rate for Payer: Galaxy Health WC |
$144.50
|
| Rate for Payer: Global Benefits Group Commercial |
$102.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$153.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$113.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.00
|
| Rate for Payer: Multiplan Commercial |
$127.50
|
| Rate for Payer: Networks By Design Commercial |
$110.50
|
| Rate for Payer: Prime Health Services Commercial |
$144.50
|
|
|
HC THERAPEUTIC PROCEDURE 30 MIN OT
|
Facility
IP
|
$202.00
|
|
| Hospital Charge Code |
901300603
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$40.40 |
| Max. Negotiated Rate |
$181.80 |
| Rate for Payer: Cash Price |
$90.90
|
| Rate for Payer: Central Health Plan Commercial |
$161.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$80.80
|
| Rate for Payer: Galaxy Health WC |
$171.70
|
| Rate for Payer: Global Benefits Group Commercial |
$121.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$181.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$134.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.40
|
| Rate for Payer: Multiplan Commercial |
$151.50
|
| Rate for Payer: Networks By Design Commercial |
$131.30
|
| Rate for Payer: Prime Health Services Commercial |
$171.70
|
|
|
HC THERAPEUTIC PROCEDURE 30 MIN OT
|
Facility
OP
|
$431.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905104139
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$122.59 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$122.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$366.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$237.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$237.05
|
| 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 |
$258.60
|
| 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 |
$193.95
|
| Rate for Payer: Cash Price |
$193.95
|
| Rate for Payer: Cash Price |
$193.95
|
| Rate for Payer: Cash Price |
$193.95
|
| Rate for Payer: Central Health Plan Commercial |
$344.80
|
| Rate for Payer: Cigna of CA HMO |
$275.84
|
| Rate for Payer: Cigna of CA PPO |
$318.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$366.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$172.40
|
| Rate for Payer: Galaxy Health WC |
$366.35
|
| Rate for Payer: Global Benefits Group Commercial |
$258.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$387.90
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$323.25
|
| Rate for Payer: IEHP medi-cal |
$150.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$287.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.71
|
| Rate for Payer: Multiplan Commercial |
$323.25
|
| Rate for Payer: Networks By Design Commercial |
$280.15
|
| Rate for Payer: Prime Health Services Commercial |
$366.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$258.60
|
| Rate for Payer: Riverside University Health MISP |
$172.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$258.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$258.60
|
| 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 |
$366.35
|
| Rate for Payer: Vantage Medical Group Senior |
$366.35
|
|
