|
HC RADIOPHARM THERAPY ORAL ADMIN
|
Facility
|
IP
|
$2,708.00
|
|
|
Service Code
|
CPT 79005
|
| Hospital Charge Code |
909301454
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$541.60 |
| Max. Negotiated Rate |
$2,437.20 |
| Rate for Payer: Cash Price |
$1,218.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,166.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,083.20
|
| Rate for Payer: Galaxy Health WC |
$2,301.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,624.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,437.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,806.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,031.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$541.60
|
| Rate for Payer: Multiplan Commercial |
$2,031.00
|
| Rate for Payer: Networks By Design Commercial |
$1,760.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,301.80
|
|
|
HC RADIOPHARM THERAPY ORAL ADMIN
|
Facility
|
OP
|
$2,708.00
|
|
|
Service Code
|
CPT 79005
|
| Hospital Charge Code |
909301454
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$226.31 |
| Max. Negotiated Rate |
$2,437.20 |
| Rate for Payer: Adventist Health Medi-Cal |
$310.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$306.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$466.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$341.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$310.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$532.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$650.09
|
| Rate for Payer: Blue Distinction Transplant |
$1,624.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1,673.54
|
| Rate for Payer: Blue Shield of California EPN |
$1,316.09
|
| Rate for Payer: Caremore Medicare Advantage |
$310.84
|
| Rate for Payer: Cash Price |
$1,218.60
|
| Rate for Payer: Cash Price |
$1,218.60
|
| Rate for Payer: Central Health Plan Commercial |
$2,166.40
|
| Rate for Payer: Cigna of CA HMO |
$1,733.12
|
| Rate for Payer: Cigna of CA PPO |
$2,003.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$466.26
|
| Rate for Payer: Dignity Health Media |
$310.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$341.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$419.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$310.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$310.84
|
| Rate for Payer: Galaxy Health WC |
$2,301.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1,624.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,437.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2,031.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$509.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$512.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$310.84
|
| Rate for Payer: InnovAge PACE Commercial |
$466.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1,806.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$226.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$310.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$541.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$416.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$416.53
|
| Rate for Payer: Multiplan Commercial |
$2,031.00
|
| Rate for Payer: Networks By Design Commercial |
$1,760.20
|
| Rate for Payer: Prime Health Services Commercial |
$2,301.80
|
| Rate for Payer: Prime Health Services Medicare |
$329.49
|
| Rate for Payer: Riverside University Health System MISP |
$341.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,624.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,624.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$589.62
|
| Rate for Payer: United Healthcare All Other HMO |
$589.62
|
| Rate for Payer: United Healthcare HMO Rider |
$589.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$589.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$466.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$341.92
|
| Rate for Payer: Vantage Medical Group Senior |
$310.84
|
|
|
HC RADIOPHARM THERAPY Y-90 ZEVALIN
|
Facility
|
IP
|
$6,537.00
|
|
|
Service Code
|
CPT 79403
|
| Hospital Charge Code |
909301344
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$1,307.40 |
| Max. Negotiated Rate |
$5,883.30 |
| Rate for Payer: Cash Price |
$2,941.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,229.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,614.80
|
| Rate for Payer: Galaxy Health WC |
$5,556.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,922.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,883.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,360.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2,490.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,307.40
|
| Rate for Payer: Multiplan Commercial |
$4,902.75
|
| Rate for Payer: Networks By Design Commercial |
$4,249.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,556.45
|
|
|
HC RADIOPHARM THERAPY Y-90 ZEVALIN
|
Facility
|
OP
|
$6,537.00
|
|
|
Service Code
|
CPT 79403
|
| Hospital Charge Code |
909301344
|
|
Hospital Revenue Code
|
342
|
| Min. Negotiated Rate |
$270.29 |
| Max. Negotiated Rate |
$5,883.30 |
| Rate for Payer: Adventist Health Medi-Cal |
$310.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$514.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$466.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$341.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$310.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$876.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,862.06
|
| Rate for Payer: Blue Distinction Transplant |
$3,922.20
|
| Rate for Payer: Blue Shield of California Commercial |
$4,039.87
|
| Rate for Payer: Blue Shield of California EPN |
$3,176.98
|
| Rate for Payer: Caremore Medicare Advantage |
$310.84
|
| Rate for Payer: Cash Price |
$2,941.65
|
| Rate for Payer: Cash Price |
$2,941.65
|
| Rate for Payer: Central Health Plan Commercial |
$5,229.60
|
| Rate for Payer: Cigna of CA HMO |
$4,183.68
|
| Rate for Payer: Cigna of CA PPO |
$4,837.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$466.26
|
| Rate for Payer: Dignity Health Media |
$310.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$341.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$419.63
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$310.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$310.84
|
| Rate for Payer: Galaxy Health WC |
$5,556.45
|
| Rate for Payer: Global Benefits Group Commercial |
$3,922.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,883.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4,902.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$509.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$512.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$310.84
|
| Rate for Payer: InnovAge PACE Commercial |
$466.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,360.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$270.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$310.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,307.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$416.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$416.53
|
| Rate for Payer: Multiplan Commercial |
$4,902.75
|
| Rate for Payer: Networks By Design Commercial |
$4,249.05
|
| Rate for Payer: Prime Health Services Commercial |
$5,556.45
|
| Rate for Payer: Prime Health Services Medicare |
$329.49
|
| Rate for Payer: Riverside University Health System MISP |
$341.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,922.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3,922.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$742.99
|
| Rate for Payer: United Healthcare All Other HMO |
$742.99
|
| Rate for Payer: United Healthcare HMO Rider |
$742.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$742.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$466.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$341.92
|
| Rate for Payer: Vantage Medical Group Senior |
$310.84
|
|
|
HC RADIOPHRM AGNT OF TMR SNGL DAY
|
Facility
|
IP
|
$4,993.00
|
|
|
Service Code
|
CPT 78802
|
| Hospital Charge Code |
909301440
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$998.60 |
| Max. Negotiated Rate |
$4,493.70 |
| Rate for Payer: Cash Price |
$2,246.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,994.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,997.20
|
| Rate for Payer: Galaxy Health WC |
$4,244.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,995.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,493.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,330.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,902.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$998.60
|
| Rate for Payer: Multiplan Commercial |
$3,744.75
|
| Rate for Payer: Networks By Design Commercial |
$3,245.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,244.05
|
|
|
HC RADIOPHRM AGNT OF TMR SNGL DAY
|
Facility
|
OP
|
$4,993.00
|
|
|
Service Code
|
CPT 78802
|
| Hospital Charge Code |
909301440
|
|
Hospital Revenue Code
|
341
|
| Min. Negotiated Rate |
$294.31 |
| Max. Negotiated Rate |
$4,493.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$1,774.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,597.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,951.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,774.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,140.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,949.86
|
| Rate for Payer: Blue Distinction Transplant |
$2,995.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3,085.67
|
| Rate for Payer: Blue Shield of California EPN |
$2,426.60
|
| Rate for Payer: Caremore Medicare Advantage |
$1,774.15
|
| Rate for Payer: Cash Price |
$2,246.85
|
| Rate for Payer: Cash Price |
$2,246.85
|
| Rate for Payer: Central Health Plan Commercial |
$3,994.40
|
| Rate for Payer: Cigna of CA HMO |
$3,195.52
|
| Rate for Payer: Cigna of CA PPO |
$3,694.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Dignity Health Media |
$1,774.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,951.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,395.10
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$1,774.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$1,774.15
|
| Rate for Payer: Galaxy Health WC |
$4,244.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2,995.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,493.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3,744.75
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$2,909.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,927.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,774.15
|
| Rate for Payer: InnovAge PACE Commercial |
$2,661.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,330.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1,774.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$998.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,377.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,377.36
|
| Rate for Payer: Multiplan Commercial |
$3,744.75
|
| Rate for Payer: Networks By Design Commercial |
$3,245.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,244.05
|
| Rate for Payer: Prime Health Services Medicare |
$1,880.60
|
| Rate for Payer: Riverside University Health System MISP |
$1,951.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,995.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,995.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,260.70
|
| Rate for Payer: United Healthcare All Other HMO |
$1,260.70
|
| Rate for Payer: United Healthcare HMO Rider |
$1,260.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,260.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2,661.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,951.56
|
| Rate for Payer: Vantage Medical Group Senior |
$1,774.15
|
|
|
HC RAGWEED WESTERN IGE
|
Facility
|
OP
|
$64.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913638
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$140.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$115.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.27
|
| Rate for Payer: Blue Distinction Transplant |
$38.40
|
| Rate for Payer: Blue Shield of California Commercial |
$39.55
|
| Rate for Payer: Blue Shield of California EPN |
$31.10
|
| Rate for Payer: Caremore Medicare Advantage |
$5.22
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: Cigna of CA HMO |
$40.96
|
| Rate for Payer: Cigna of CA PPO |
$47.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.83
|
| Rate for Payer: Dignity Health Media |
$5.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.05
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$5.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.22
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$48.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$8.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$5.22
|
| Rate for Payer: InnovAge PACE Commercial |
$7.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
| Rate for Payer: Prime Health Services Medicare |
$5.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.22
|
|
|
HC RAGWEED WESTERN IGE
|
Facility
|
IP
|
$64.00
|
|
|
Service Code
|
CPT 86003
|
| Hospital Charge Code |
900913638
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$12.80 |
| Max. Negotiated Rate |
$57.60 |
| Rate for Payer: Cash Price |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$51.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.60
|
| Rate for Payer: Galaxy Health WC |
$54.40
|
| Rate for Payer: Global Benefits Group Commercial |
$38.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.80
|
| Rate for Payer: Multiplan Commercial |
$48.00
|
| Rate for Payer: Networks By Design Commercial |
$41.60
|
| Rate for Payer: Prime Health Services Commercial |
$54.40
|
|
|
HC RANGE OF MOTION EXTR/TRUNK EA MCAL
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 95851
|
| Hospital Charge Code |
900400016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$28.23 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$169.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$133.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$184.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$197.12
|
| Rate for Payer: Cigna of CA PPO |
$227.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$261.80
|
| Rate for Payer: Dignity Health Media |
$261.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$231.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$107.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.28
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
| Rate for Payer: Riverside University Health System MISP |
$123.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$184.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$184.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Vantage Medical Group Senior |
$261.80
|
|
|
HC RANGE OF MOTION EXTR/TRUNK EA MCAL
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 95851
|
| Hospital Charge Code |
900400016
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
|
HC RANGE OF MOTION EXTR/TRUNK EA PT
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 95851
|
| Hospital Charge Code |
900419061
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$28.23 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$169.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$133.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$184.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$197.12
|
| Rate for Payer: Cigna of CA PPO |
$227.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$261.80
|
| Rate for Payer: Dignity Health Media |
$261.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$231.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$107.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.28
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
| Rate for Payer: Riverside University Health System MISP |
$123.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$184.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$184.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Vantage Medical Group Senior |
$261.80
|
|
|
HC RANGE OF MOTION EXTR/TRUNK EA PT
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 95851
|
| Hospital Charge Code |
900419061
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
|
HC RANGE OF MOTION EXTR/TRUNK EA PT
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 95851
|
| Hospital Charge Code |
905103406
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
|
HC RANGE OF MOTION EXTR/TRUNK EA PT
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 95851
|
| Hospital Charge Code |
905103406
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$28.23 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$169.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$133.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$184.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$197.12
|
| Rate for Payer: Cigna of CA PPO |
$227.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$261.80
|
| Rate for Payer: Dignity Health Media |
$261.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$231.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$107.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.28
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
| Rate for Payer: Riverside University Health System MISP |
$123.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$184.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$184.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Vantage Medical Group Senior |
$261.80
|
|
|
HC RANGE OF MOTION MEAS HAND
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 95852
|
| Hospital Charge Code |
905104407
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
|
HC RANGE OF MOTION MEAS HAND
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 95852
|
| Hospital Charge Code |
905103407
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.97 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$169.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$184.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$197.12
|
| Rate for Payer: Cigna of CA PPO |
$227.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$261.80
|
| Rate for Payer: Dignity Health Media |
$261.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$231.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$107.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.28
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
| Rate for Payer: Riverside University Health System MISP |
$123.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$184.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$184.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Vantage Medical Group Senior |
$261.80
|
|
|
HC RANGE OF MOTION MEAS HAND
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 95852
|
| Hospital Charge Code |
905104407
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$30.97 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$169.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$184.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$197.12
|
| Rate for Payer: Cigna of CA PPO |
$227.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$261.80
|
| Rate for Payer: Dignity Health Media |
$261.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$231.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$107.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.28
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
| Rate for Payer: Riverside University Health System MISP |
$123.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$184.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$184.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Vantage Medical Group Senior |
$261.80
|
|
|
HC RANGE OF MOTION MEAS HAND
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 95852
|
| Hospital Charge Code |
900419062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
|
HC RANGE OF MOTION MEAS HAND
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 95852
|
| Hospital Charge Code |
900419062
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.97 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$169.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$184.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$197.12
|
| Rate for Payer: Cigna of CA PPO |
$227.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$261.80
|
| Rate for Payer: Dignity Health Media |
$261.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$231.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$107.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.28
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
| Rate for Payer: Riverside University Health System MISP |
$123.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$184.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$184.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Vantage Medical Group Senior |
$261.80
|
|
|
HC RANGE OF MOTION MEAS HAND
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 95852
|
| Hospital Charge Code |
905103407
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
|
HC RANGE OF MOTION MEAS HAND MCAL
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 95852
|
| Hospital Charge Code |
900400018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
|
HC RANGE OF MOTION MEAS HAND MCAL
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 95852
|
| Hospital Charge Code |
901300033
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$30.97 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$169.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$184.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$197.12
|
| Rate for Payer: Cigna of CA PPO |
$227.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$261.80
|
| Rate for Payer: Dignity Health Media |
$261.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$231.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$107.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.28
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
| Rate for Payer: Riverside University Health System MISP |
$123.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$184.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$184.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Vantage Medical Group Senior |
$261.80
|
|
|
HC RANGE OF MOTION MEAS HAND MCAL
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 95852
|
| Hospital Charge Code |
901300033
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
|
HC RANGE OF MOTION MEAS HAND MCAL
|
Facility
|
OP
|
$308.00
|
|
|
Service Code
|
CPT 95852
|
| Hospital Charge Code |
900400018
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$30.97 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$261.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$169.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$169.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$184.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: Cigna of CA HMO |
$197.12
|
| Rate for Payer: Cigna of CA PPO |
$227.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$261.80
|
| Rate for Payer: Dignity Health Media |
$261.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$231.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$107.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$30.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$126.28
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
| Rate for Payer: Riverside University Health System MISP |
$123.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$184.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$184.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$261.80
|
| Rate for Payer: Vantage Medical Group Senior |
$261.80
|
|
|
HC RANGE OF MOTION MEAS LIMB/TRUNK MCAL
|
Facility
|
IP
|
$308.00
|
|
|
Service Code
|
CPT 95851
|
| Hospital Charge Code |
901300031
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$61.60 |
| Max. Negotiated Rate |
$277.20 |
| Rate for Payer: Cash Price |
$138.60
|
| Rate for Payer: Central Health Plan Commercial |
$246.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.20
|
| Rate for Payer: Galaxy Health WC |
$261.80
|
| Rate for Payer: Global Benefits Group Commercial |
$184.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$277.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$205.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.60
|
| Rate for Payer: Multiplan Commercial |
$231.00
|
| Rate for Payer: Networks By Design Commercial |
$200.20
|
| Rate for Payer: Prime Health Services Commercial |
$261.80
|
|
