Montclair Hospital Medical Center
5000 San Bernardino Road
Montclair, CA 91763
Acute Care Hospitals
Overview
- CMS rating★★★☆☆
- CCN050758
Clinical quality
- CMS Star Rating3/5
Procedures & prices
- HYDRALAZINE HCL INJECTIONJ0360$10cashGross $120 payers
- HC MOD SED SAME PHYS/QHP EA99153$10cashGross $3500 payers
- Ostomy irrigation bagA4398$10cashGross $100 payers
- HC RHO IG HUMAN FULL DOSE IM90384$11cashGross $350 payers
- Cath indw foley 2 way silicnA4344$11cashGross $110 payers
- Alginate drsg >16 <=48 sq inA6197$11cashGross $110 payers
- Hydrocolld drg >16<=48 w/o bA6235$11cashGross $110 payers
- HC PT PHYSICAL MEDICINE PROCEDURE GP97139$11cashGross $400 payers
- HC MICROBE SUSCEPTIBLE, MIC87186$11cashGross $2160 payers
- HC RENAL FUNCTION PANEL80069$11cashGross $3890 payers
| Procedure | Code | Cash↑ | Gross | Negotiated range | Payers |
|---|---|---|---|---|---|
| HYDRALAZINE HCL INJECTION | J0360 | $10 | $12 | — | 0 |
| HC MOD SED SAME PHYS/QHP EA | 99153 | $10 | $350 | — | 0 |
| Ostomy irrigation bag | A4398 | $10 | $10 | — | 0 |
| HC RHO IG HUMAN FULL DOSE IM | 90384 | $11 | $35 | — | 0 |
| Cath indw foley 2 way silicn | A4344 | $11 | $11 | — | 0 |
| Alginate drsg >16 <=48 sq in | A6197 | $11 | $11 | — | 0 |
| Hydrocolld drg >16<=48 w/o b | A6235 | $11 | $11 | — | 0 |
| HC PT PHYSICAL MEDICINE PROCEDURE GP | 97139 | $11 | $40 | — | 0 |
| HC MICROBE SUSCEPTIBLE, MIC | 87186 | $11 | $216 | — | 0 |
| HC RENAL FUNCTION PANEL | 80069 | $11 | $389 | — | 0 |
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