|
HC CASE CONF INITIAL 30 MIN
|
Facility
IP
|
$154.00
|
|
| Hospital Charge Code |
900409040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$138.60 |
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.60
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.80
|
| Rate for Payer: Multiplan Commercial |
$115.50
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
|
|
HC CASE CONF INITIAL 30 MIN
|
Facility
IP
|
$154.00
|
|
| Hospital Charge Code |
901309040
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$30.80 |
| Max. Negotiated Rate |
$138.60 |
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.60
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.80
|
| Rate for Payer: Multiplan Commercial |
$115.50
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
|
|
HC CASE CONF INITIAL 30 MIN
|
Facility
IP
|
$169.00
|
|
| Hospital Charge Code |
905104306
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$33.80 |
| Max. Negotiated Rate |
$152.10 |
| Rate for Payer: Cash Price |
$76.05
|
| Rate for Payer: Central Health Plan Commercial |
$135.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.60
|
| Rate for Payer: Galaxy Health WC |
$143.65
|
| Rate for Payer: Global Benefits Group Commercial |
$101.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$152.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$112.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.80
|
| Rate for Payer: Multiplan Commercial |
$126.75
|
| Rate for Payer: Networks By Design Commercial |
$109.85
|
| Rate for Payer: Prime Health Services Commercial |
$143.65
|
|
|
HC CASE CONF INITIAL 30 MIN
|
Facility
OP
|
$169.00
|
|
| Hospital Charge Code |
905104306
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$59.15 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$102.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$143.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$92.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$92.95
|
| 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 |
$101.40
|
| 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 |
$76.05
|
| Rate for Payer: Cash Price |
$76.05
|
| Rate for Payer: Cash Price |
$76.05
|
| Rate for Payer: Central Health Plan Commercial |
$135.20
|
| Rate for Payer: Cigna of CA HMO |
$108.16
|
| Rate for Payer: Cigna of CA PPO |
$125.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$143.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$67.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$67.60
|
| Rate for Payer: Galaxy Health WC |
$143.65
|
| Rate for Payer: Global Benefits Group Commercial |
$101.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$152.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$126.75
|
| Rate for Payer: IEHP medi-cal |
$59.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$112.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.29
|
| Rate for Payer: Multiplan Commercial |
$126.75
|
| Rate for Payer: Networks By Design Commercial |
$109.85
|
| Rate for Payer: Prime Health Services Commercial |
$143.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$101.40
|
| Rate for Payer: Riverside University Health MISP |
$67.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$101.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$101.40
|
| 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 |
$143.65
|
| Rate for Payer: Vantage Medical Group Senior |
$143.65
|
|
|
HC CASE CONF INITIAL 30 MIN
|
Facility
OP
|
$154.00
|
|
| Hospital Charge Code |
900409040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$53.90 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$93.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$130.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$84.70
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$84.70
|
| 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 |
$92.40
|
| 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 |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Cash Price |
$69.30
|
| Rate for Payer: Central Health Plan Commercial |
$123.20
|
| Rate for Payer: Cigna of CA HMO |
$98.56
|
| Rate for Payer: Cigna of CA PPO |
$113.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$130.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$61.60
|
| Rate for Payer: Galaxy Health WC |
$130.90
|
| Rate for Payer: Global Benefits Group Commercial |
$92.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$115.50
|
| Rate for Payer: IEHP medi-cal |
$53.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.14
|
| Rate for Payer: Multiplan Commercial |
$115.50
|
| Rate for Payer: Networks By Design Commercial |
$100.10
|
| Rate for Payer: Prime Health Services Commercial |
$130.90
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$92.40
|
| Rate for Payer: Riverside University Health MISP |
$61.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.40
|
| 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 |
$130.90
|
| Rate for Payer: Vantage Medical Group Senior |
$130.90
|
|
|
HC CASE CONSULT
|
Facility
IP
|
$146.00
|
|
| Hospital Charge Code |
905104308
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$29.20 |
| Max. Negotiated Rate |
$131.40 |
| Rate for Payer: Cash Price |
$65.70
|
| Rate for Payer: Central Health Plan Commercial |
$116.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.40
|
| Rate for Payer: Galaxy Health WC |
$124.10
|
| Rate for Payer: Global Benefits Group Commercial |
$87.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$131.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$97.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.20
|
| Rate for Payer: Multiplan Commercial |
$109.50
|
| Rate for Payer: Networks By Design Commercial |
$94.90
|
| Rate for Payer: Prime Health Services Commercial |
$124.10
|
|
|
HC CASE CONSULT
|
Facility
OP
|
$146.00
|
|
| Hospital Charge Code |
905104308
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$51.10 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$88.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$124.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$80.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$80.30
|
| 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 |
$87.60
|
| 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 |
$65.70
|
| Rate for Payer: Cash Price |
$65.70
|
| Rate for Payer: Cash Price |
$65.70
|
| Rate for Payer: Central Health Plan Commercial |
$116.80
|
| Rate for Payer: Cigna of CA HMO |
$93.44
|
| Rate for Payer: Cigna of CA PPO |
$108.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$124.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$58.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$58.40
|
| Rate for Payer: Galaxy Health WC |
$124.10
|
| Rate for Payer: Global Benefits Group Commercial |
$87.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$131.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$109.50
|
| Rate for Payer: IEHP medi-cal |
$51.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$97.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.86
|
| Rate for Payer: Multiplan Commercial |
$109.50
|
| Rate for Payer: Networks By Design Commercial |
$94.90
|
| Rate for Payer: Prime Health Services Commercial |
$124.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$87.60
|
| Rate for Payer: Riverside University Health MISP |
$58.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$87.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$87.60
|
| 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 |
$124.10
|
| Rate for Payer: Vantage Medical Group Senior |
$124.10
|
|
|
HC CASH ASPIR/INJ MAJOR JOINT/BURSA W US GDNC
|
Facility
OP
|
$772.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
906620612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.40 |
| Max. Negotiated Rate |
$7,084.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$370.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$370.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$463.20
|
| Rate for Payer: Blue Shield of California Commercial |
$951.13
|
| Rate for Payer: Blue Shield of California EPN |
$683.14
|
| Rate for Payer: Caremore Medicare Advantage |
$370.06
|
| Rate for Payer: Cash Price |
$347.40
|
| Rate for Payer: Cash Price |
$347.40
|
| Rate for Payer: Central Health Plan Commercial |
$617.60
|
| Rate for Payer: Cigna of CA PPO |
$571.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$555.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$499.58
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$370.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$370.06
|
| Rate for Payer: Galaxy Health WC |
$656.20
|
| Rate for Payer: Global Benefits Group Commercial |
$463.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$694.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$579.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$606.90
|
| Rate for Payer: IEHP medi-cal |
$610.60
|
| Rate for Payer: IEHP Medicare Advantage |
$370.06
|
| Rate for Payer: Innovage PACE Commercial |
$555.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$514.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$495.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$495.88
|
| Rate for Payer: Multiplan Commercial |
$579.00
|
| Rate for Payer: Networks By Design Commercial |
$501.80
|
| Rate for Payer: Prime Health Services Commercial |
$656.20
|
| Rate for Payer: Prime Health Services Medicare |
$392.26
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$463.20
|
| Rate for Payer: Riverside University Health MISP |
$407.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$463.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$555.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$407.07
|
| Rate for Payer: Vantage Medical Group Senior |
$370.06
|
|
|
HC CASH ASPIR/INJ MAJOR JOINT/BURSA W US GDNC
|
Facility
IP
|
$772.00
|
|
|
Service Code
|
CPT 20611
|
| Hospital Charge Code |
906620612
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$154.40 |
| Max. Negotiated Rate |
$694.80 |
| Rate for Payer: Cash Price |
$347.40
|
| Rate for Payer: Central Health Plan Commercial |
$617.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$308.80
|
| Rate for Payer: Galaxy Health WC |
$656.20
|
| Rate for Payer: Global Benefits Group Commercial |
$463.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$694.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$514.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.40
|
| Rate for Payer: Multiplan Commercial |
$579.00
|
| Rate for Payer: Networks By Design Commercial |
$501.80
|
| Rate for Payer: Prime Health Services Commercial |
$656.20
|
|
|
HC CASH DUAL ROBOTIC THERAPY SESS
|
Facility
IP
|
$326.00
|
|
|
Service Code
|
CPT 97799
|
| Hospital Charge Code |
915197800
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$293.40 |
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$293.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$217.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.20
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
|
|
HC CASH DUAL ROBOTIC THERAPY SESS
|
Facility
OP
|
$326.00
|
|
|
Service Code
|
CPT 97799
|
| Hospital Charge Code |
915197800
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$114.10 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$197.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$277.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$179.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$179.30
|
| 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 |
$195.60
|
| 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 |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: Cigna of CA HMO |
$208.64
|
| Rate for Payer: Cigna of CA PPO |
$241.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$130.40
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$293.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$244.50
|
| Rate for Payer: IEHP medi-cal |
$114.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$217.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.66
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$195.60
|
| Rate for Payer: Riverside University Health MISP |
$130.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.60
|
| 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 |
$277.10
|
| Rate for Payer: Vantage Medical Group Senior |
$277.10
|
|
|
HC CASH DUAL ROBOTIC THERAPY SESS
|
Facility
OP
|
$326.00
|
|
|
Service Code
|
CPT 97799
|
| Hospital Charge Code |
905197800
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$114.10 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$197.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$277.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$179.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$179.30
|
| 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 |
$195.60
|
| 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 |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: Cigna of CA HMO |
$208.64
|
| Rate for Payer: Cigna of CA PPO |
$241.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$130.40
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$293.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$244.50
|
| Rate for Payer: IEHP medi-cal |
$114.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$217.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.66
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$195.60
|
| Rate for Payer: Riverside University Health MISP |
$130.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.60
|
| 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 |
$277.10
|
| Rate for Payer: Vantage Medical Group Senior |
$277.10
|
|
|
HC CASH DUAL ROBOTIC THERAPY SESS
|
Facility
IP
|
$326.00
|
|
|
Service Code
|
CPT 97799
|
| Hospital Charge Code |
905197800
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$293.40 |
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$293.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$217.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.20
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
|
|
HC CASH MAIN PROGRAM PER MONTH
|
Facility
OP
|
$116.00
|
|
| Hospital Charge Code |
903200198
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$98.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$63.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$63.80
|
| 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 |
$69.60
|
| 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 |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Central Health Plan Commercial |
$92.80
|
| Rate for Payer: Cigna of CA HMO |
$74.24
|
| Rate for Payer: Cigna of CA PPO |
$85.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$46.40
|
| Rate for Payer: Galaxy Health WC |
$98.60
|
| Rate for Payer: Global Benefits Group Commercial |
$69.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$87.00
|
| Rate for Payer: IEHP medi-cal |
$40.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.56
|
| Rate for Payer: Multiplan Commercial |
$87.00
|
| Rate for Payer: Networks By Design Commercial |
$75.40
|
| Rate for Payer: Prime Health Services Commercial |
$98.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$69.60
|
| Rate for Payer: Riverside University Health MISP |
$46.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.60
|
| 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 |
$98.60
|
| Rate for Payer: Vantage Medical Group Senior |
$98.60
|
|
|
HC CASH MAIN PROGRAM PER MONTH
|
Facility
OP
|
$109.00
|
|
| Hospital Charge Code |
900419070
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$38.15 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$66.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$92.65
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$59.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$59.95
|
| 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 |
$65.40
|
| 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 |
$49.05
|
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Central Health Plan Commercial |
$87.20
|
| Rate for Payer: Cigna of CA HMO |
$69.76
|
| Rate for Payer: Cigna of CA PPO |
$80.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$92.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$43.60
|
| Rate for Payer: Galaxy Health WC |
$92.65
|
| Rate for Payer: Global Benefits Group Commercial |
$65.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$98.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$81.75
|
| Rate for Payer: IEHP medi-cal |
$38.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$44.69
|
| Rate for Payer: Multiplan Commercial |
$81.75
|
| Rate for Payer: Networks By Design Commercial |
$70.85
|
| Rate for Payer: Prime Health Services Commercial |
$92.65
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$65.40
|
| Rate for Payer: Riverside University Health MISP |
$43.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$65.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$65.40
|
| 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 |
$92.65
|
| Rate for Payer: Vantage Medical Group Senior |
$92.65
|
|
|
HC CASH MAIN PROGRAM PER MONTH
|
Facility
IP
|
$116.00
|
|
| Hospital Charge Code |
903200198
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$104.40 |
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Central Health Plan Commercial |
$92.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.40
|
| Rate for Payer: Galaxy Health WC |
$98.60
|
| Rate for Payer: Global Benefits Group Commercial |
$69.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.20
|
| Rate for Payer: Multiplan Commercial |
$87.00
|
| Rate for Payer: Networks By Design Commercial |
$75.40
|
| Rate for Payer: Prime Health Services Commercial |
$98.60
|
|
|
HC CASH MAIN PROGRAM PER MONTH
|
Facility
IP
|
$109.00
|
|
| Hospital Charge Code |
900419070
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$21.80 |
| Max. Negotiated Rate |
$98.10 |
| Rate for Payer: Cash Price |
$49.05
|
| Rate for Payer: Central Health Plan Commercial |
$87.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.60
|
| Rate for Payer: Galaxy Health WC |
$92.65
|
| Rate for Payer: Global Benefits Group Commercial |
$65.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$98.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.80
|
| Rate for Payer: Multiplan Commercial |
$81.75
|
| Rate for Payer: Networks By Design Commercial |
$70.85
|
| Rate for Payer: Prime Health Services Commercial |
$92.65
|
|
|
HC CASH MAINT PROGRAM PER MONTH
|
Facility
OP
|
$116.00
|
|
| Hospital Charge Code |
903201198
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$40.60 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$70.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$98.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$63.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$63.80
|
| 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 |
$69.60
|
| 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 |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Central Health Plan Commercial |
$92.80
|
| Rate for Payer: Cigna of CA HMO |
$74.24
|
| Rate for Payer: Cigna of CA PPO |
$85.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$98.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$46.40
|
| Rate for Payer: Galaxy Health WC |
$98.60
|
| Rate for Payer: Global Benefits Group Commercial |
$69.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$87.00
|
| Rate for Payer: IEHP medi-cal |
$40.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$47.56
|
| Rate for Payer: Multiplan Commercial |
$87.00
|
| Rate for Payer: Networks By Design Commercial |
$75.40
|
| Rate for Payer: Prime Health Services Commercial |
$98.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$69.60
|
| Rate for Payer: Riverside University Health MISP |
$46.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$69.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$69.60
|
| 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 |
$98.60
|
| Rate for Payer: Vantage Medical Group Senior |
$98.60
|
|
|
HC CASH MAINT PROGRAM PER MONTH
|
Facility
IP
|
$116.00
|
|
| Hospital Charge Code |
903201198
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$23.20 |
| Max. Negotiated Rate |
$104.40 |
| Rate for Payer: Cash Price |
$52.20
|
| Rate for Payer: Central Health Plan Commercial |
$92.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.40
|
| Rate for Payer: Galaxy Health WC |
$98.60
|
| Rate for Payer: Global Benefits Group Commercial |
$69.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$104.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$77.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.20
|
| Rate for Payer: Multiplan Commercial |
$87.00
|
| Rate for Payer: Networks By Design Commercial |
$75.40
|
| Rate for Payer: Prime Health Services Commercial |
$98.60
|
|
|
HC CASH ROBOTIC THERAPY SESSION
|
Facility
OP
|
$326.00
|
|
|
Service Code
|
CPT 97799
|
| Hospital Charge Code |
915197799
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$114.10 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$197.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$277.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$179.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$179.30
|
| 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 |
$195.60
|
| 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 |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: Cigna of CA HMO |
$208.64
|
| Rate for Payer: Cigna of CA PPO |
$241.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$130.40
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$293.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$244.50
|
| Rate for Payer: IEHP medi-cal |
$114.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$217.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.66
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$195.60
|
| Rate for Payer: Riverside University Health MISP |
$130.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.60
|
| 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 |
$277.10
|
| Rate for Payer: Vantage Medical Group Senior |
$277.10
|
|
|
HC CASH ROBOTIC THERAPY SESSION
|
Facility
IP
|
$326.00
|
|
|
Service Code
|
CPT 97799
|
| Hospital Charge Code |
915197799
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$293.40 |
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$293.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$217.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.20
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
|
|
HC CASH ROBOTIC THERAPY SESSION
|
Facility
IP
|
$326.00
|
|
|
Service Code
|
CPT 97799
|
| Hospital Charge Code |
905197799
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$65.20 |
| Max. Negotiated Rate |
$293.40 |
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$293.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$217.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$65.20
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
|
|
HC CASH ROBOTIC THERAPY SESSION
|
Facility
OP
|
$326.00
|
|
|
Service Code
|
CPT 97799
|
| Hospital Charge Code |
905197799
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$114.10 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$197.98
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$277.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$179.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$179.30
|
| 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 |
$195.60
|
| 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 |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Cash Price |
$146.70
|
| Rate for Payer: Central Health Plan Commercial |
$260.80
|
| Rate for Payer: Cigna of CA HMO |
$208.64
|
| Rate for Payer: Cigna of CA PPO |
$241.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$277.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$130.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$130.40
|
| Rate for Payer: Galaxy Health WC |
$277.10
|
| Rate for Payer: Global Benefits Group Commercial |
$195.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$293.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$244.50
|
| Rate for Payer: IEHP medi-cal |
$114.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$217.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$133.66
|
| Rate for Payer: Multiplan Commercial |
$244.50
|
| Rate for Payer: Networks By Design Commercial |
$211.90
|
| Rate for Payer: Prime Health Services Commercial |
$277.10
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$195.60
|
| Rate for Payer: Riverside University Health MISP |
$130.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$195.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$195.60
|
| 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 |
$277.10
|
| Rate for Payer: Vantage Medical Group Senior |
$277.10
|
|
|
HC CASTING 3" TCC-EZ SINGLE APP
|
Facility
IP
|
$580.00
|
|
|
Service Code
|
CPT Q4038
|
| Hospital Charge Code |
901698310
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
|
|
HC CASTING 3" TCC-EZ SINGLE APP
|
Facility
OP
|
$580.00
|
|
|
Service Code
|
CPT Q4038
|
| Hospital Charge Code |
901698310
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$116.00 |
| Max. Negotiated Rate |
$522.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$214.50
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$493.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$319.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$319.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$280.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$342.66
|
| Rate for Payer: BCBS Transplant Transplant |
$348.00
|
| Rate for Payer: Blue Shield of California Commercial |
$364.82
|
| Rate for Payer: Blue Shield of California EPN |
$283.62
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Cash Price |
$261.00
|
| Rate for Payer: Central Health Plan Commercial |
$464.00
|
| Rate for Payer: Cigna of CA HMO |
$371.20
|
| Rate for Payer: Cigna of CA PPO |
$429.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$493.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$232.00
|
| Rate for Payer: Galaxy Health WC |
$493.00
|
| Rate for Payer: Global Benefits Group Commercial |
$348.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$522.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$435.00
|
| Rate for Payer: IEHP medi-cal |
$203.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$386.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.00
|
| Rate for Payer: Multiplan Commercial |
$435.00
|
| Rate for Payer: Networks By Design Commercial |
$377.00
|
| Rate for Payer: Prime Health Services Commercial |
$493.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: Riverside University Health MISP |
$232.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$348.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$348.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$290.00
|
| Rate for Payer: United Healthcare All Other HMO |
$290.00
|
| Rate for Payer: United Healthcare HMO Rider |
$290.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$290.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$493.00
|
| Rate for Payer: Vantage Medical Group Senior |
$493.00
|
|
