|
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 |
$132.55
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| 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 Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| 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 |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$146.36
|
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| 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: 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: InnovAge PACE Commercial |
$120.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$168.70
|
| Rate for Payer: Molina Healthcare of CA 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 |
900410478
|
|
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 |
$132.55
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| 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 Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| 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 |
905103225
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$146.36
|
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| 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: 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: InnovAge PACE Commercial |
$120.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$168.70
|
| Rate for Payer: Molina Healthcare of CA 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 ST
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905601304
|
|
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 |
$132.55
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| 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 Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| 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 ST
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905601304
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$146.36
|
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| 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: 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: InnovAge PACE Commercial |
$120.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$168.70
|
| Rate for Payer: Molina Healthcare of CA 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 30MIN MCAL
|
Facility
|
IP
|
$180.00
|
|
| Hospital Charge Code |
900409030
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$36.00 |
| Max. Negotiated Rate |
$162.00 |
| Rate for Payer: Adventist Health Commercial |
$36.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
|
|
HC THERAPEUTIC PROCEDURE 30MIN MCAL
|
Facility
|
OP
|
$180.00
|
|
| Hospital Charge Code |
900409030
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$68.58 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$73.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$109.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$153.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$99.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$135.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Cash Price |
$99.00
|
| Rate for Payer: Central Health Plan Commercial |
$144.00
|
| Rate for Payer: Cigna of CA HMO |
$115.20
|
| Rate for Payer: Cigna of CA PPO |
$133.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$153.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$153.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$153.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.00
|
| Rate for Payer: EPIC Health Plan Senior |
$72.00
|
| Rate for Payer: Galaxy Health WC |
$153.00
|
| Rate for Payer: Global Benefits Group Commercial |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$162.00
|
| Rate for Payer: InnovAge PACE Commercial |
$90.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$120.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.58
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$111.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$126.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$126.00
|
| Rate for Payer: Multiplan Commercial |
$135.00
|
| Rate for Payer: Networks By Design Commercial |
$117.00
|
| Rate for Payer: Prime Health Services Commercial |
$153.00
|
| Rate for Payer: Riverside University Health System MISP |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$108.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$108.00
|
| 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 |
$153.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$153.00
|
| Rate for Payer: Vantage Medical Group Senior |
$153.00
|
|
|
HC THERAPEUTIC PROCEDURE 30 MIN OT
|
Facility
|
IP
|
$214.00
|
|
| Hospital Charge Code |
901300603
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$42.80 |
| Max. Negotiated Rate |
$192.60 |
| Rate for Payer: Adventist Health Commercial |
$42.80
|
| Rate for Payer: Cash Price |
$117.70
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.60
|
| Rate for Payer: EPIC Health Plan Senior |
$85.60
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$132.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.80
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
|
|
HC THERAPEUTIC PROCEDURE 30 MIN OT
|
Facility
|
OP
|
$348.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905104139
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$142.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$211.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$295.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$191.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$261.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$191.40
|
| Rate for Payer: Cash Price |
$191.40
|
| Rate for Payer: Cash Price |
$191.40
|
| Rate for Payer: Cash Price |
$191.40
|
| Rate for Payer: Central Health Plan Commercial |
$278.40
|
| Rate for Payer: Cigna of CA HMO |
$222.72
|
| Rate for Payer: Cigna of CA PPO |
$257.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$295.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$295.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$139.20
|
| Rate for Payer: EPIC Health Plan Senior |
$139.20
|
| Rate for Payer: Galaxy Health WC |
$295.80
|
| Rate for Payer: Global Benefits Group Commercial |
$208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$313.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.85
|
| Rate for Payer: InnovAge PACE Commercial |
$174.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$232.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$215.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$243.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$243.60
|
| Rate for Payer: Multiplan Commercial |
$261.00
|
| Rate for Payer: Networks By Design Commercial |
$226.20
|
| Rate for Payer: Prime Health Services Commercial |
$295.80
|
| Rate for Payer: Riverside University Health System MISP |
$139.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$208.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$208.80
|
| 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 |
$295.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$295.80
|
| Rate for Payer: Vantage Medical Group Senior |
$295.80
|
|
|
HC THERAPEUTIC PROCEDURE 30 MIN OT
|
Facility
|
IP
|
$348.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
905104139
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$69.60 |
| Max. Negotiated Rate |
$313.20 |
| Rate for Payer: Adventist Health Commercial |
$69.60
|
| Rate for Payer: Cash Price |
$191.40
|
| Rate for Payer: Central Health Plan Commercial |
$278.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$139.20
|
| Rate for Payer: EPIC Health Plan Senior |
$139.20
|
| Rate for Payer: Galaxy Health WC |
$295.80
|
| Rate for Payer: Global Benefits Group Commercial |
$208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$313.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$232.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$132.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$215.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.60
|
| Rate for Payer: Multiplan Commercial |
$261.00
|
| Rate for Payer: Networks By Design Commercial |
$226.20
|
| Rate for Payer: Prime Health Services Commercial |
$295.80
|
|
|
HC THERAPEUTIC PROCEDURE 30 MIN OT
|
Facility
|
OP
|
$214.00
|
|
| Hospital Charge Code |
901300603
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$81.53 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$87.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$129.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$181.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$117.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$160.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$117.70
|
| Rate for Payer: Cash Price |
$117.70
|
| Rate for Payer: Cash Price |
$117.70
|
| Rate for Payer: Central Health Plan Commercial |
$171.20
|
| Rate for Payer: Cigna of CA HMO |
$136.96
|
| Rate for Payer: Cigna of CA PPO |
$158.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$181.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$181.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$181.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$85.60
|
| Rate for Payer: EPIC Health Plan Senior |
$85.60
|
| Rate for Payer: Galaxy Health WC |
$181.90
|
| Rate for Payer: Global Benefits Group Commercial |
$128.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$192.60
|
| Rate for Payer: InnovAge PACE Commercial |
$107.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$142.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$81.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$132.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$149.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$149.80
|
| Rate for Payer: Multiplan Commercial |
$160.50
|
| Rate for Payer: Networks By Design Commercial |
$139.10
|
| Rate for Payer: Prime Health Services Commercial |
$181.90
|
| Rate for Payer: Riverside University Health System MISP |
$85.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$128.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$128.40
|
| 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 |
$181.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$181.90
|
| Rate for Payer: Vantage Medical Group Senior |
$181.90
|
|
|
HC THERAPEUTIC PROCEDURE ADDL 15MIN PT
|
Facility
|
IP
|
$108.00
|
|
| Hospital Charge Code |
900409031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$97.20 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Central Health Plan Commercial |
$86.40
|
| 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 Permanente of CA Commercial/Self Funded |
$72.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66.85
|
| 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 ADDL 15MIN PT
|
Facility
|
OP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
900410402
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.85 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$98.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$146.36
|
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| Rate for Payer: Cash Price |
$132.55
|
| 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: 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: InnovAge PACE Commercial |
$120.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$98.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$168.70
|
| Rate for Payer: Molina Healthcare of CA 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 ADDL 15MIN PT
|
Facility
|
IP
|
$241.00
|
|
|
Service Code
|
CPT 97110
|
| Hospital Charge Code |
900410402
|
|
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 |
$132.55
|
| Rate for Payer: Central Health Plan Commercial |
$192.80
|
| 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 Permanente of CA Commercial/Self Funded |
$160.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$149.18
|
| 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 ADDL 15MIN PT
|
Facility
|
OP
|
$108.00
|
|
| Hospital Charge Code |
900409031
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$41.15 |
| Max. Negotiated Rate |
$447.00 |
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| Rate for Payer: Cash Price |
$59.40
|
| 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: 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: InnovAge PACE Commercial |
$54.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75.60
|
| Rate for Payer: Molina Healthcare of CA 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 GRP MCAL
|
Facility
|
OP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
901300059
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$23.29 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$193.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$287.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$402.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$354.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: Cigna of CA HMO |
$302.72
|
| Rate for Payer: Cigna of CA PPO |
$350.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$402.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$402.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$402.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.29
|
| Rate for Payer: InnovAge PACE Commercial |
$236.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.10
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
| Rate for Payer: Riverside University Health System MISP |
$189.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$283.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$283.80
|
| 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 |
$402.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$402.05
|
| Rate for Payer: Vantage Medical Group Senior |
$402.05
|
|
|
HC THERAPEUTIC PROCEDURE GRP MCAL
|
Facility
|
IP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
900400055
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$94.60 |
| Max. Negotiated Rate |
$425.70 |
| Rate for Payer: Adventist Health Commercial |
$94.60
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.60
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
|
|
HC THERAPEUTIC PROCEDURE GRP MCAL
|
Facility
|
OP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
900400055
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.29 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$193.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$287.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$402.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$354.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: Cigna of CA HMO |
$302.72
|
| Rate for Payer: Cigna of CA PPO |
$350.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$402.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$402.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$402.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.29
|
| Rate for Payer: InnovAge PACE Commercial |
$236.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.10
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
| Rate for Payer: Riverside University Health System MISP |
$189.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$283.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$283.80
|
| 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 |
$402.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$402.05
|
| Rate for Payer: Vantage Medical Group Senior |
$402.05
|
|
|
HC THERAPEUTIC PROCEDURE GRP MCAL
|
Facility
|
IP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
901300059
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$94.60 |
| Max. Negotiated Rate |
$425.70 |
| Rate for Payer: Adventist Health Commercial |
$94.60
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.60
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
|
|
HC THERAPEUTIC PROCEDURE GRP OT
|
Facility
|
IP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
905104147
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$94.60 |
| Max. Negotiated Rate |
$425.70 |
| Rate for Payer: Adventist Health Commercial |
$94.60
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.60
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
|
|
HC THERAPEUTIC PROCEDURE GRP OT
|
Facility
|
OP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
905104147
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$23.29 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$193.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$287.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$402.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$354.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: Cigna of CA HMO |
$302.72
|
| Rate for Payer: Cigna of CA PPO |
$350.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$402.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$402.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$402.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.29
|
| Rate for Payer: InnovAge PACE Commercial |
$236.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.10
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
| Rate for Payer: Riverside University Health System MISP |
$189.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$283.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$283.80
|
| 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 |
$402.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$402.05
|
| Rate for Payer: Vantage Medical Group Senior |
$402.05
|
|
|
HC THERAPEUTIC PROCEDURE GRP PT
|
Facility
|
OP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
905103147
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.29 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$193.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$287.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$402.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$354.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: Cigna of CA HMO |
$302.72
|
| Rate for Payer: Cigna of CA PPO |
$350.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$402.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$402.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$402.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.29
|
| Rate for Payer: InnovAge PACE Commercial |
$236.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.10
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
| Rate for Payer: Riverside University Health System MISP |
$189.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$283.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$283.80
|
| 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 |
$402.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$402.05
|
| Rate for Payer: Vantage Medical Group Senior |
$402.05
|
|
|
HC THERAPEUTIC PROCEDURE GRP PT
|
Facility
|
IP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
905103147
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$94.60 |
| Max. Negotiated Rate |
$425.70 |
| Rate for Payer: Adventist Health Commercial |
$94.60
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$94.60
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
|
|
HC THERAPEUTIC PROCEDURE GRP PT COMM MCARE
|
Facility
|
OP
|
$473.00
|
|
|
Service Code
|
CPT 97150
|
| Hospital Charge Code |
900417151
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.29 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$193.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$287.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$402.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$260.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$354.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Cash Price |
$260.15
|
| Rate for Payer: Central Health Plan Commercial |
$378.40
|
| Rate for Payer: Cigna of CA HMO |
$302.72
|
| Rate for Payer: Cigna of CA PPO |
$350.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$402.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$402.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$402.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.20
|
| Rate for Payer: EPIC Health Plan Senior |
$189.20
|
| Rate for Payer: Galaxy Health WC |
$402.05
|
| Rate for Payer: Global Benefits Group Commercial |
$283.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$425.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$23.29
|
| Rate for Payer: InnovAge PACE Commercial |
$236.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$193.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$331.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$331.10
|
| Rate for Payer: Multiplan Commercial |
$354.75
|
| Rate for Payer: Networks By Design Commercial |
$307.45
|
| Rate for Payer: Prime Health Services Commercial |
$402.05
|
| Rate for Payer: Riverside University Health System MISP |
$189.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$283.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$283.80
|
| 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 |
$402.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$402.05
|
| Rate for Payer: Vantage Medical Group Senior |
$402.05
|
|
