|
HC PHYSICAL PERF TEST 15 MIN PT
|
Facility
|
IP
|
$184.00
|
|
|
Service Code
|
CPT 97750
|
| Hospital Charge Code |
905103156
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$36.80 |
| Max. Negotiated Rate |
$165.60 |
| Rate for Payer: Adventist Health Commercial |
$36.80
|
| Rate for Payer: Cash Price |
$101.20
|
| Rate for Payer: Central Health Plan Commercial |
$147.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$73.60
|
| Rate for Payer: EPIC Health Plan Senior |
$73.60
|
| Rate for Payer: Galaxy Health WC |
$156.40
|
| Rate for Payer: Global Benefits Group Commercial |
$110.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$165.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$122.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$70.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.80
|
| Rate for Payer: Multiplan Commercial |
$138.00
|
| Rate for Payer: Networks By Design Commercial |
$119.60
|
| Rate for Payer: Prime Health Services Commercial |
$156.40
|
|
|
HC PHYSICIAN CONF PARTICIP 30 MIN
|
Facility
|
IP
|
$128.00
|
|
|
Service Code
|
CPT 99367
|
| Hospital Charge Code |
908600144
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Adventist Health Commercial |
$25.60
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Central Health Plan Commercial |
$102.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Senior |
$51.20
|
| Rate for Payer: Galaxy Health WC |
$108.80
|
| Rate for Payer: Global Benefits Group Commercial |
$76.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.60
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$83.20
|
| Rate for Payer: Prime Health Services Commercial |
$108.80
|
|
|
HC PHYSICIAN CONF PARTICIP 30 MIN
|
Facility
|
OP
|
$128.00
|
|
|
Service Code
|
CPT 99367
|
| Hospital Charge Code |
908600144
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$25.60 |
| Max. Negotiated Rate |
$115.20 |
| Rate for Payer: Adventist Health Commercial |
$25.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$108.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$70.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$96.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$61.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.17
|
| Rate for Payer: Blue Shield of California Commercial |
$78.21
|
| Rate for Payer: Blue Shield of California EPN |
$51.07
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Cash Price |
$70.40
|
| Rate for Payer: Central Health Plan Commercial |
$102.40
|
| Rate for Payer: Cigna of CA HMO |
$81.92
|
| Rate for Payer: Cigna of CA PPO |
$94.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$108.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Senior |
$51.20
|
| Rate for Payer: Galaxy Health WC |
$108.80
|
| Rate for Payer: Global Benefits Group Commercial |
$76.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$83.01
|
| Rate for Payer: InnovAge PACE Commercial |
$64.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$91.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$79.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$89.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$89.60
|
| Rate for Payer: Multiplan Commercial |
$96.00
|
| Rate for Payer: Networks By Design Commercial |
$83.20
|
| Rate for Payer: Prime Health Services Commercial |
$108.80
|
| Rate for Payer: Riverside University Health System MISP |
$51.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$76.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$76.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$64.00
|
| Rate for Payer: United Healthcare All Other HMO |
$64.00
|
| Rate for Payer: United Healthcare HMO Rider |
$64.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$64.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$108.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.80
|
| Rate for Payer: Vantage Medical Group Senior |
$108.80
|
|
|
HC PHYSIOLOGIC EXERCISE STUDY
|
Facility
|
IP
|
$1,194.00
|
|
|
Service Code
|
CPT 93464
|
| Hospital Charge Code |
906811411
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$238.80 |
| Max. Negotiated Rate |
$1,074.60 |
| Rate for Payer: Adventist Health Commercial |
$238.80
|
| Rate for Payer: Cash Price |
$656.70
|
| Rate for Payer: Central Health Plan Commercial |
$955.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$477.60
|
| Rate for Payer: EPIC Health Plan Senior |
$477.60
|
| Rate for Payer: Galaxy Health WC |
$1,014.90
|
| Rate for Payer: Global Benefits Group Commercial |
$716.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,074.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$796.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$454.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$739.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$238.80
|
| Rate for Payer: Multiplan Commercial |
$895.50
|
| Rate for Payer: Networks By Design Commercial |
$776.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,014.90
|
|
|
HC PHYSIOLOGIC EXERCISE STUDY
|
Facility
|
OP
|
$1,194.00
|
|
|
Service Code
|
CPT 93464
|
| Hospital Charge Code |
906811411
|
|
Hospital Revenue Code
|
481
|
| Min. Negotiated Rate |
$238.80 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$238.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,014.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$656.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$895.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,378.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$701.24
|
| Rate for Payer: Blue Shield of California Commercial |
$979.68
|
| Rate for Payer: Blue Shield of California EPN |
$639.21
|
| Rate for Payer: Cash Price |
$656.70
|
| Rate for Payer: Cash Price |
$656.70
|
| Rate for Payer: Cash Price |
$656.70
|
| Rate for Payer: Central Health Plan Commercial |
$955.20
|
| Rate for Payer: Cigna of CA HMO |
$776.10
|
| Rate for Payer: Cigna of CA PPO |
$883.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,014.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,014.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,014.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$477.60
|
| Rate for Payer: EPIC Health Plan Senior |
$477.60
|
| Rate for Payer: Galaxy Health WC |
$1,014.90
|
| Rate for Payer: Global Benefits Group Commercial |
$716.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,074.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.67
|
| Rate for Payer: InnovAge PACE Commercial |
$597.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$796.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$427.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$739.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$238.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$835.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$835.80
|
| Rate for Payer: Multiplan Commercial |
$895.50
|
| Rate for Payer: Networks By Design Commercial |
$776.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,014.90
|
| Rate for Payer: Riverside University Health System MISP |
$477.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$716.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,800.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,932.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,014.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,014.90
|
| Rate for Payer: Vantage Medical Group Senior |
$1,014.90
|
|
|
HC PHYS THER ANY TEST/MEASURE ADDL 15 MIN
|
Facility
|
OP
|
$172.00
|
|
| Hospital Charge Code |
905103310
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$65.53 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$70.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$104.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$146.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$94.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$129.00
|
| 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 |
$94.60
|
| Rate for Payer: Cash Price |
$94.60
|
| Rate for Payer: Cash Price |
$94.60
|
| Rate for Payer: Central Health Plan Commercial |
$137.60
|
| Rate for Payer: Cigna of CA HMO |
$110.08
|
| Rate for Payer: Cigna of CA PPO |
$127.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$146.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$146.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$146.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.80
|
| Rate for Payer: EPIC Health Plan Senior |
$68.80
|
| Rate for Payer: Galaxy Health WC |
$146.20
|
| Rate for Payer: Global Benefits Group Commercial |
$103.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$154.80
|
| Rate for Payer: InnovAge PACE Commercial |
$86.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$106.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$120.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$120.40
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Networks By Design Commercial |
$111.80
|
| Rate for Payer: Prime Health Services Commercial |
$146.20
|
| Rate for Payer: Riverside University Health System MISP |
$68.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$103.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$103.20
|
| 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 |
$146.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$146.20
|
| Rate for Payer: Vantage Medical Group Senior |
$146.20
|
|
|
HC PHYS THER ANY TEST/MEASURE ADDL 15 MIN
|
Facility
|
IP
|
$172.00
|
|
| Hospital Charge Code |
905103310
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$34.40 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Cash Price |
$94.60
|
| Rate for Payer: Central Health Plan Commercial |
$137.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.80
|
| Rate for Payer: EPIC Health Plan Senior |
$68.80
|
| Rate for Payer: Galaxy Health WC |
$146.20
|
| Rate for Payer: Global Benefits Group Commercial |
$103.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$154.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$106.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.40
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Networks By Design Commercial |
$111.80
|
| Rate for Payer: Prime Health Services Commercial |
$146.20
|
|
|
HC PHYS THER ANY TEST/MEASURE ADDL 15 MIN MCAL
|
Facility
|
OP
|
$172.00
|
|
| Hospital Charge Code |
900413922
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$65.53 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$70.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$104.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$146.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$94.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$129.00
|
| 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 |
$94.60
|
| Rate for Payer: Cash Price |
$94.60
|
| Rate for Payer: Cash Price |
$94.60
|
| Rate for Payer: Central Health Plan Commercial |
$137.60
|
| Rate for Payer: Cigna of CA HMO |
$110.08
|
| Rate for Payer: Cigna of CA PPO |
$127.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$146.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$146.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$146.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.80
|
| Rate for Payer: EPIC Health Plan Senior |
$68.80
|
| Rate for Payer: Galaxy Health WC |
$146.20
|
| Rate for Payer: Global Benefits Group Commercial |
$103.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$154.80
|
| Rate for Payer: InnovAge PACE Commercial |
$86.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$106.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$70.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$120.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$120.40
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Networks By Design Commercial |
$111.80
|
| Rate for Payer: Prime Health Services Commercial |
$146.20
|
| Rate for Payer: Riverside University Health System MISP |
$68.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$103.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$103.20
|
| 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 |
$146.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$146.20
|
| Rate for Payer: Vantage Medical Group Senior |
$146.20
|
|
|
HC PHYS THER ANY TEST/MEASURE ADDL 15 MIN MCAL
|
Facility
|
IP
|
$172.00
|
|
| Hospital Charge Code |
900413922
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$34.40 |
| Max. Negotiated Rate |
$154.80 |
| Rate for Payer: Adventist Health Commercial |
$34.40
|
| Rate for Payer: Cash Price |
$94.60
|
| Rate for Payer: Central Health Plan Commercial |
$137.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$68.80
|
| Rate for Payer: EPIC Health Plan Senior |
$68.80
|
| Rate for Payer: Galaxy Health WC |
$146.20
|
| Rate for Payer: Global Benefits Group Commercial |
$103.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$154.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$114.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$65.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$106.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.40
|
| Rate for Payer: Multiplan Commercial |
$129.00
|
| Rate for Payer: Networks By Design Commercial |
$111.80
|
| Rate for Payer: Prime Health Services Commercial |
$146.20
|
|
|
HC PHYS THER ANY TEST/MEASURE INIT 30 MIN PT
|
Facility
|
OP
|
$330.00
|
|
| Hospital Charge Code |
905103309
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$125.73 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$135.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$200.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$280.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$181.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.50
|
| 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 |
$181.50
|
| Rate for Payer: Cash Price |
$181.50
|
| Rate for Payer: Cash Price |
$181.50
|
| Rate for Payer: Central Health Plan Commercial |
$264.00
|
| Rate for Payer: Cigna of CA HMO |
$211.20
|
| Rate for Payer: Cigna of CA PPO |
$244.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$280.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$280.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$280.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.00
|
| Rate for Payer: EPIC Health Plan Senior |
$132.00
|
| Rate for Payer: Galaxy Health WC |
$280.50
|
| Rate for Payer: Global Benefits Group Commercial |
$198.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$297.00
|
| Rate for Payer: InnovAge PACE Commercial |
$165.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$220.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$231.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$231.00
|
| Rate for Payer: Multiplan Commercial |
$247.50
|
| Rate for Payer: Networks By Design Commercial |
$214.50
|
| Rate for Payer: Prime Health Services Commercial |
$280.50
|
| Rate for Payer: Riverside University Health System MISP |
$132.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$198.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.00
|
| 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 |
$280.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$280.50
|
| Rate for Payer: Vantage Medical Group Senior |
$280.50
|
|
|
HC PHYS THER ANY TEST/MEASURE INIT 30 MIN PT
|
Facility
|
IP
|
$330.00
|
|
| Hospital Charge Code |
905103309
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$297.00 |
| Rate for Payer: Adventist Health Commercial |
$66.00
|
| Rate for Payer: Cash Price |
$181.50
|
| Rate for Payer: Central Health Plan Commercial |
$264.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.00
|
| Rate for Payer: EPIC Health Plan Senior |
$132.00
|
| Rate for Payer: Galaxy Health WC |
$280.50
|
| Rate for Payer: Global Benefits Group Commercial |
$198.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$297.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$220.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$247.50
|
| Rate for Payer: Networks By Design Commercial |
$214.50
|
| Rate for Payer: Prime Health Services Commercial |
$280.50
|
|
|
HC PHYS THER ANY TEST/MEASURE INIT 30 MIN PT MCAL
|
Facility
|
OP
|
$330.00
|
|
| Hospital Charge Code |
900413920
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$125.73 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$135.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$200.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$280.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$181.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$247.50
|
| 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 |
$181.50
|
| Rate for Payer: Cash Price |
$181.50
|
| Rate for Payer: Cash Price |
$181.50
|
| Rate for Payer: Central Health Plan Commercial |
$264.00
|
| Rate for Payer: Cigna of CA HMO |
$211.20
|
| Rate for Payer: Cigna of CA PPO |
$244.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$280.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$280.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$280.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.00
|
| Rate for Payer: EPIC Health Plan Senior |
$132.00
|
| Rate for Payer: Galaxy Health WC |
$280.50
|
| Rate for Payer: Global Benefits Group Commercial |
$198.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$297.00
|
| Rate for Payer: InnovAge PACE Commercial |
$165.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$220.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$135.30
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$231.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$231.00
|
| Rate for Payer: Multiplan Commercial |
$247.50
|
| Rate for Payer: Networks By Design Commercial |
$214.50
|
| Rate for Payer: Prime Health Services Commercial |
$280.50
|
| Rate for Payer: Riverside University Health System MISP |
$132.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$198.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$198.00
|
| 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 |
$280.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$280.50
|
| Rate for Payer: Vantage Medical Group Senior |
$280.50
|
|
|
HC PHYS THER ANY TEST/MEASURE INIT 30 MIN PT MCAL
|
Facility
|
IP
|
$330.00
|
|
| Hospital Charge Code |
900413920
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$66.00 |
| Max. Negotiated Rate |
$297.00 |
| Rate for Payer: Adventist Health Commercial |
$66.00
|
| Rate for Payer: Cash Price |
$181.50
|
| Rate for Payer: Central Health Plan Commercial |
$264.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$132.00
|
| Rate for Payer: EPIC Health Plan Senior |
$132.00
|
| Rate for Payer: Galaxy Health WC |
$280.50
|
| Rate for Payer: Global Benefits Group Commercial |
$198.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$297.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$220.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$125.73
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$66.00
|
| Rate for Payer: Multiplan Commercial |
$247.50
|
| Rate for Payer: Networks By Design Commercial |
$214.50
|
| Rate for Payer: Prime Health Services Commercial |
$280.50
|
|
|
HC PHYS THER APP OF SURFACE NEUROSTIMULATOR
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
CPT 64550
|
| Hospital Charge Code |
905103350
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$243.00 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Central Health Plan Commercial |
$216.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$180.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$167.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
|
|
HC PHYS THER APP OF SURFACE NEUROSTIMULATOR
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
CPT 64550
|
| Hospital Charge Code |
905103350
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$102.87 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$110.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$229.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$202.50
|
| 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 |
$148.50
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Central Health Plan Commercial |
$216.00
|
| Rate for Payer: Cigna of CA HMO |
$172.80
|
| Rate for Payer: Cigna of CA PPO |
$199.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$229.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$229.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.00
|
| Rate for Payer: InnovAge PACE Commercial |
$135.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$180.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$167.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$189.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$189.00
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
| Rate for Payer: Riverside University Health System MISP |
$108.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$162.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$162.00
|
| 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 |
$229.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.50
|
| Rate for Payer: Vantage Medical Group Senior |
$229.50
|
|
|
HC PHYS THER APP OF SURFACE NEUROSTIMULATOR COMM MCARE
|
Facility
|
OP
|
$270.00
|
|
|
Service Code
|
CPT 64550
|
| Hospital Charge Code |
900419074
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$102.87 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$110.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$229.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$148.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$202.50
|
| 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 |
$148.50
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Central Health Plan Commercial |
$216.00
|
| Rate for Payer: Cigna of CA HMO |
$172.80
|
| Rate for Payer: Cigna of CA PPO |
$199.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$229.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$229.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$229.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.00
|
| Rate for Payer: InnovAge PACE Commercial |
$135.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$180.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$167.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$110.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$189.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$189.00
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
| Rate for Payer: Riverside University Health System MISP |
$108.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$162.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$162.00
|
| 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 |
$229.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$229.50
|
| Rate for Payer: Vantage Medical Group Senior |
$229.50
|
|
|
HC PHYS THER APP OF SURFACE NEUROSTIMULATOR COMM MCARE
|
Facility
|
IP
|
$270.00
|
|
|
Service Code
|
CPT 64550
|
| Hospital Charge Code |
900419074
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$54.00 |
| Max. Negotiated Rate |
$243.00 |
| Rate for Payer: Adventist Health Commercial |
$54.00
|
| Rate for Payer: Cash Price |
$148.50
|
| Rate for Payer: Central Health Plan Commercial |
$216.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$108.00
|
| Rate for Payer: EPIC Health Plan Senior |
$108.00
|
| Rate for Payer: Galaxy Health WC |
$229.50
|
| Rate for Payer: Global Benefits Group Commercial |
$162.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$243.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$180.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$167.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$54.00
|
| Rate for Payer: Multiplan Commercial |
$202.50
|
| Rate for Payer: Networks By Design Commercial |
$175.50
|
| Rate for Payer: Prime Health Services Commercial |
$229.50
|
|
|
HC PHYS THER CASE CONF EA ADDL 15 MIN
|
Facility
|
IP
|
$98.00
|
|
| Hospital Charge Code |
905103307
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$19.60 |
| Max. Negotiated Rate |
$88.20 |
| Rate for Payer: Adventist Health Commercial |
$19.60
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
|
|
HC PHYS THER CASE CONF EA ADDL 15 MIN
|
Facility
|
OP
|
$98.00
|
|
| Hospital Charge Code |
905103307
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$37.34 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$40.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$59.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$83.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$73.50
|
| 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 |
$53.90
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Cash Price |
$53.90
|
| Rate for Payer: Central Health Plan Commercial |
$78.40
|
| Rate for Payer: Cigna of CA HMO |
$62.72
|
| Rate for Payer: Cigna of CA PPO |
$72.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$83.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$83.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$83.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.20
|
| Rate for Payer: EPIC Health Plan Senior |
$39.20
|
| Rate for Payer: Galaxy Health WC |
$83.30
|
| Rate for Payer: Global Benefits Group Commercial |
$58.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.20
|
| Rate for Payer: InnovAge PACE Commercial |
$49.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$37.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$60.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$40.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$68.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$68.60
|
| Rate for Payer: Multiplan Commercial |
$73.50
|
| Rate for Payer: Networks By Design Commercial |
$63.70
|
| Rate for Payer: Prime Health Services Commercial |
$83.30
|
| Rate for Payer: Riverside University Health System MISP |
$39.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.80
|
| 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 |
$83.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.30
|
| Rate for Payer: Vantage Medical Group Senior |
$83.30
|
|
|
HC PHYS THER CASE CONF EA ADDL 15 MIN MCAL
|
Facility
|
OP
|
$94.00
|
|
| Hospital Charge Code |
900419041
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$38.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$79.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$51.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$70.50
|
| 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 |
$51.70
|
| Rate for Payer: Cash Price |
$51.70
|
| Rate for Payer: Cash Price |
$51.70
|
| Rate for Payer: Central Health Plan Commercial |
$75.20
|
| Rate for Payer: Cigna of CA HMO |
$60.16
|
| Rate for Payer: Cigna of CA PPO |
$69.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$79.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$79.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$79.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
| Rate for Payer: EPIC Health Plan Senior |
$37.60
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.60
|
| Rate for Payer: InnovAge PACE Commercial |
$47.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$38.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$65.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$65.80
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
| Rate for Payer: Riverside University Health System MISP |
$37.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$56.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$56.40
|
| 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 |
$79.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$79.90
|
| Rate for Payer: Vantage Medical Group Senior |
$79.90
|
|
|
HC PHYS THER CASE CONF EA ADDL 15 MIN MCAL
|
Facility
|
IP
|
$94.00
|
|
| Hospital Charge Code |
900419041
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$18.80 |
| Max. Negotiated Rate |
$84.60 |
| Rate for Payer: Adventist Health Commercial |
$18.80
|
| Rate for Payer: Cash Price |
$51.70
|
| Rate for Payer: Central Health Plan Commercial |
$75.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$37.60
|
| Rate for Payer: EPIC Health Plan Senior |
$37.60
|
| Rate for Payer: Galaxy Health WC |
$79.90
|
| Rate for Payer: Global Benefits Group Commercial |
$56.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$84.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$62.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$58.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.80
|
| Rate for Payer: Multiplan Commercial |
$70.50
|
| Rate for Payer: Networks By Design Commercial |
$61.10
|
| Rate for Payer: Prime Health Services Commercial |
$79.90
|
|
|
HC PHYS THER CASE CONF INITIAL 30 MIN
|
Facility
|
OP
|
$125.00
|
|
| Hospital Charge Code |
905103306
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$47.62 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$51.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$75.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$106.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$68.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$93.75
|
| 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 |
$68.75
|
| Rate for Payer: Cash Price |
$68.75
|
| Rate for Payer: Cash Price |
$68.75
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: Cigna of CA HMO |
$80.00
|
| Rate for Payer: Cigna of CA PPO |
$92.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$106.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$106.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$106.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: EPIC Health Plan Senior |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: InnovAge PACE Commercial |
$62.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$51.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$87.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$87.50
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
| Rate for Payer: Riverside University Health System MISP |
$50.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.00
|
| 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 |
$106.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$106.25
|
| Rate for Payer: Vantage Medical Group Senior |
$106.25
|
|
|
HC PHYS THER CASE CONF INITIAL 30 MIN
|
Facility
|
IP
|
$125.00
|
|
| Hospital Charge Code |
905103306
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$25.00 |
| Max. Negotiated Rate |
$112.50 |
| Rate for Payer: Adventist Health Commercial |
$25.00
|
| Rate for Payer: Cash Price |
$68.75
|
| Rate for Payer: Central Health Plan Commercial |
$100.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.00
|
| Rate for Payer: EPIC Health Plan Senior |
$50.00
|
| Rate for Payer: Galaxy Health WC |
$106.25
|
| Rate for Payer: Global Benefits Group Commercial |
$75.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$112.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.00
|
| Rate for Payer: Multiplan Commercial |
$93.75
|
| Rate for Payer: Networks By Design Commercial |
$81.25
|
| Rate for Payer: Prime Health Services Commercial |
$106.25
|
|
|
HC PHYS THER CASE CONF INITIAL 30 MIN MCAL
|
Facility
|
IP
|
$120.00
|
|
| Hospital Charge Code |
900419040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$24.00 |
| Max. Negotiated Rate |
$108.00 |
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
|
|
HC PHYS THER CASE CONF INITIAL 30 MIN MCAL
|
Facility
|
OP
|
$120.00
|
|
| Hospital Charge Code |
900419040
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$45.72 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$49.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.00
|
| 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 |
$66.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Cigna of CA HMO |
$76.80
|
| Rate for Payer: Cigna of CA PPO |
$88.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$102.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$102.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: InnovAge PACE Commercial |
$60.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$84.00
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$78.00
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Riverside University Health System MISP |
$48.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.00
|
| 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 |
$102.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.00
|
| Rate for Payer: Vantage Medical Group Senior |
$102.00
|
|
