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California rates for HCPCS G2004

Comprehensive (60 minutes) in-home visit for a new patient postdischarge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than nine times.)

Facilitymedian $219 · 10th–90th $174–$5500%10%20%10th90th$219Professionalmedian $162 · 10th–90th $135–$3160%10%20%10th90th$162$100.0$200.0$500.0$1.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $162.18 / $186.21
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $151.36 / $194.98
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $218.78 / $549.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $223.87 / $549.54
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $204.17 / $380.19
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $208.93 / $257.04
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $169.82 / $269.15
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,288.25 / $1,288.25
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $181.97 / $251.19
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $181.97
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $204.17 / $457.09