|
HC EVAL OF FNA,EA ADDLL SITE PG
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
903800217
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$44.49 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$44.49
|
| Rate for Payer: Blue Shield of California Commercial |
$9.37
|
| Rate for Payer: Blue Shield of California EPN |
$6.19
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Cigna of CA HMO |
$8.96
|
| Rate for Payer: Cigna of CA PPO |
$10.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5.60
|
| Rate for Payer: Galaxy Health WC |
$11.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$36.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.80
|
| Rate for Payer: Multiplan Commercial |
$11.20
|
| Rate for Payer: Networks By Design Commercial |
$9.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.89
|
| Rate for Payer: United Healthcare All Other HMO |
$5.89
|
| Rate for Payer: United Healthcare HMO Rider |
$5.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.90
|
| Rate for Payer: Vantage Medical Group Senior |
$11.90
|
|
|
HC EVAL OF FNA INITIAL PG
|
Facility
|
OP
|
$314.00
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
903800216
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$47.53 |
| Max. Negotiated Rate |
$357.08 |
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$205.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$102.74
|
| Rate for Payer: Blue Shield of California Commercial |
$210.07
|
| Rate for Payer: Blue Shield of California EPN |
$138.79
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Cigna of CA HMO |
$200.96
|
| Rate for Payer: Cigna of CA PPO |
$232.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.94
|
| Rate for Payer: EPIC Health Plan Senior |
$217.73
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Heritage Provider Network Commercial |
$357.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$47.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$209.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$217.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$274.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$291.76
|
| Rate for Payer: Multiplan Commercial |
$251.20
|
| Rate for Payer: Networks By Design Commercial |
$204.10
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$188.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$188.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$217.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC EVAL OF FNA INITIAL PG
|
Facility
|
IP
|
$314.00
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
903800216
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$62.80 |
| Max. Negotiated Rate |
$266.90 |
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$125.60
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$209.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$75.36
|
| Rate for Payer: Multiplan Commercial |
$251.20
|
| Rate for Payer: Networks By Design Commercial |
$204.10
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
|
|
HC EVAL/REVAL FOR PRESCRIPT SPCH DEVICE MCAL
|
Facility
|
IP
|
$455.00
|
|
|
Service Code
|
CPT 92605
|
| Hospital Charge Code |
907000025
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$91.00 |
| Max. Negotiated Rate |
$386.75 |
| Rate for Payer: Adventist Health Commercial |
$91.00
|
| Rate for Payer: Cash Price |
$250.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.00
|
| Rate for Payer: EPIC Health Plan Senior |
$182.00
|
| Rate for Payer: Galaxy Health WC |
$386.75
|
| Rate for Payer: Global Benefits Group Commercial |
$273.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$303.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$173.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$281.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.20
|
| Rate for Payer: Multiplan Commercial |
$364.00
|
| Rate for Payer: Networks By Design Commercial |
$295.75
|
| Rate for Payer: Prime Health Services Commercial |
$386.75
|
|
|
HC EVAL/REVAL FOR PRESCRIPT SPCH DEVICE MCAL
|
Facility
|
OP
|
$455.00
|
|
|
Service Code
|
CPT 92605
|
| Hospital Charge Code |
907000025
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$58.40 |
| Max. Negotiated Rate |
$457.00 |
| Rate for Payer: Adventist Health Commercial |
$186.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$298.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$386.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$250.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$341.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$250.25
|
| Rate for Payer: Cash Price |
$250.25
|
| Rate for Payer: Cash Price |
$250.25
|
| Rate for Payer: Cash Price |
$250.25
|
| Rate for Payer: Cigna of CA HMO |
$291.20
|
| Rate for Payer: Cigna of CA PPO |
$336.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$386.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$386.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$386.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$182.00
|
| Rate for Payer: EPIC Health Plan Senior |
$182.00
|
| Rate for Payer: Galaxy Health WC |
$386.75
|
| Rate for Payer: Global Benefits Group Commercial |
$273.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$58.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$303.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$281.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$318.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$318.50
|
| Rate for Payer: Multiplan Commercial |
$364.00
|
| Rate for Payer: Networks By Design Commercial |
$295.75
|
| Rate for Payer: Prime Health Services Commercial |
$386.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$273.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$273.00
|
| 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 |
$386.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$386.75
|
| Rate for Payer: Vantage Medical Group Senior |
$386.75
|
|
|
HC EVAL RX SPEECH DVC 1ST HR MCAL
|
Facility
|
OP
|
$598.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
907000017
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$143.52 |
| Max. Negotiated Rate |
$508.30 |
| Rate for Payer: Adventist Health Commercial |
$245.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$392.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$508.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$328.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$448.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: Cigna of CA HMO |
$382.72
|
| Rate for Payer: Cigna of CA PPO |
$442.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$508.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$508.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$508.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$161.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$418.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$418.60
|
| Rate for Payer: Multiplan Commercial |
$478.40
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$358.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$358.80
|
| 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 |
$508.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$508.30
|
| Rate for Payer: Vantage Medical Group Senior |
$508.30
|
|
|
HC EVAL RX SPEECH DVC 1ST HR MCAL
|
Facility
|
IP
|
$598.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
907000017
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$119.60 |
| Max. Negotiated Rate |
$508.30 |
| Rate for Payer: Adventist Health Commercial |
$119.60
|
| Rate for Payer: Cash Price |
$328.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$239.20
|
| Rate for Payer: EPIC Health Plan Senior |
$239.20
|
| Rate for Payer: Galaxy Health WC |
$508.30
|
| Rate for Payer: Global Benefits Group Commercial |
$358.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$398.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$227.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$370.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$143.52
|
| Rate for Payer: Multiplan Commercial |
$478.40
|
| Rate for Payer: Networks By Design Commercial |
$388.70
|
| Rate for Payer: Prime Health Services Commercial |
$508.30
|
|
|
HC EVAL RX SPEECH DVC EA ADDL 30MIN MCAL
|
Facility
|
IP
|
$259.00
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
907000019
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$51.80 |
| Max. Negotiated Rate |
$220.15 |
| Rate for Payer: Adventist Health Commercial |
$51.80
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.60
|
| Rate for Payer: EPIC Health Plan Senior |
$103.60
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$98.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$160.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.16
|
| Rate for Payer: Multiplan Commercial |
$207.20
|
| Rate for Payer: Networks By Design Commercial |
$168.35
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
|
|
HC EVAL RX SPEECH DVC EA ADDL 30MIN MCAL
|
Facility
|
OP
|
$259.00
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
907000019
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$31.58 |
| Max. Negotiated Rate |
$457.00 |
| Rate for Payer: Adventist Health Commercial |
$106.19
|
| Rate for Payer: Aetna of CA HMO/PPO |
$169.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$220.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$142.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$194.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Cash Price |
$142.45
|
| Rate for Payer: Cigna of CA HMO |
$165.76
|
| Rate for Payer: Cigna of CA PPO |
$191.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$220.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$220.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$220.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$103.60
|
| Rate for Payer: EPIC Health Plan Senior |
$103.60
|
| Rate for Payer: Galaxy Health WC |
$220.15
|
| Rate for Payer: Global Benefits Group Commercial |
$155.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$31.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$172.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$160.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$181.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$181.30
|
| Rate for Payer: Multiplan Commercial |
$207.20
|
| Rate for Payer: Networks By Design Commercial |
$168.35
|
| Rate for Payer: Prime Health Services Commercial |
$220.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$155.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$155.40
|
| 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 |
$220.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$220.15
|
| Rate for Payer: Vantage Medical Group Senior |
$220.15
|
|
|
HC EVAL SPEECH FLUENCY
|
Facility
|
IP
|
$797.00
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
900100000
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$159.40 |
| Max. Negotiated Rate |
$677.45 |
| Rate for Payer: Adventist Health Commercial |
$159.40
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$318.80
|
| Rate for Payer: EPIC Health Plan Senior |
$318.80
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$531.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$303.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$493.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.28
|
| Rate for Payer: Multiplan Commercial |
$637.60
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
|
|
HC EVAL SPEECH FLUENCY
|
Facility
|
OP
|
$797.00
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
900100000
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$125.97 |
| Max. Negotiated Rate |
$677.45 |
| Rate for Payer: Adventist Health Commercial |
$326.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$522.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$677.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$438.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$597.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: Cash Price |
$438.35
|
| Rate for Payer: Cigna of CA HMO |
$510.08
|
| Rate for Payer: Cigna of CA PPO |
$589.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$677.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$677.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$677.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$318.80
|
| Rate for Payer: EPIC Health Plan Senior |
$318.80
|
| Rate for Payer: Galaxy Health WC |
$677.45
|
| Rate for Payer: Global Benefits Group Commercial |
$478.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$125.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$531.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$493.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$191.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$557.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$557.90
|
| Rate for Payer: Multiplan Commercial |
$637.60
|
| Rate for Payer: Networks By Design Commercial |
$518.05
|
| Rate for Payer: Prime Health Services Commercial |
$677.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$478.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$478.20
|
| 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 |
$677.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$677.45
|
| Rate for Payer: Vantage Medical Group Senior |
$677.45
|
|
|
HC EVAL SPEECH/LANGUAGE/VOICE PRELIM MCAL
|
Facility
|
OP
|
$823.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000021
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$49.93 |
| Max. Negotiated Rate |
$699.55 |
| Rate for Payer: Adventist Health Commercial |
$337.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$539.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$699.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$452.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$617.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$452.65
|
| Rate for Payer: Cash Price |
$452.65
|
| Rate for Payer: Cash Price |
$452.65
|
| Rate for Payer: Cash Price |
$452.65
|
| Rate for Payer: Cigna of CA HMO |
$526.72
|
| Rate for Payer: Cigna of CA PPO |
$609.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$699.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$699.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$699.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$329.20
|
| Rate for Payer: EPIC Health Plan Senior |
$329.20
|
| Rate for Payer: Galaxy Health WC |
$699.55
|
| Rate for Payer: Global Benefits Group Commercial |
$493.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$49.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$548.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$509.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$576.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$576.10
|
| Rate for Payer: Multiplan Commercial |
$658.40
|
| Rate for Payer: Networks By Design Commercial |
$534.95
|
| Rate for Payer: Prime Health Services Commercial |
$699.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$493.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$493.80
|
| 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 |
$699.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$699.55
|
| Rate for Payer: Vantage Medical Group Senior |
$699.55
|
|
|
HC EVAL SPEECH/LANGUAGE/VOICE PRELIM MCAL
|
Facility
|
IP
|
$823.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000021
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$164.60 |
| Max. Negotiated Rate |
$699.55 |
| Rate for Payer: Adventist Health Commercial |
$164.60
|
| Rate for Payer: Cash Price |
$452.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$329.20
|
| Rate for Payer: EPIC Health Plan Senior |
$329.20
|
| Rate for Payer: Galaxy Health WC |
$699.55
|
| Rate for Payer: Global Benefits Group Commercial |
$493.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$548.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$313.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$509.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$197.52
|
| Rate for Payer: Multiplan Commercial |
$658.40
|
| Rate for Payer: Networks By Design Commercial |
$534.95
|
| Rate for Payer: Prime Health Services Commercial |
$699.55
|
|
|
HC EVAL SPEECH SOUND PRODUCTION
|
Facility
|
IP
|
$642.00
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
900100001
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$128.40 |
| Max. Negotiated Rate |
$545.70 |
| Rate for Payer: Adventist Health Commercial |
$128.40
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.80
|
| Rate for Payer: EPIC Health Plan Senior |
$256.80
|
| Rate for Payer: Galaxy Health WC |
$545.70
|
| Rate for Payer: Global Benefits Group Commercial |
$385.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$428.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$244.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$397.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.08
|
| Rate for Payer: Multiplan Commercial |
$513.60
|
| Rate for Payer: Networks By Design Commercial |
$417.30
|
| Rate for Payer: Prime Health Services Commercial |
$545.70
|
|
|
HC EVAL SPEECH SOUND PRODUCTION
|
Facility
|
OP
|
$642.00
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
900100001
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$90.45 |
| Max. Negotiated Rate |
$545.70 |
| Rate for Payer: Adventist Health Commercial |
$263.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$421.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$545.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$353.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$481.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cigna of CA HMO |
$410.88
|
| Rate for Payer: Cigna of CA PPO |
$475.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$545.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$545.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$545.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.80
|
| Rate for Payer: EPIC Health Plan Senior |
$256.80
|
| Rate for Payer: Galaxy Health WC |
$545.70
|
| Rate for Payer: Global Benefits Group Commercial |
$385.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$90.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$428.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$397.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.40
|
| Rate for Payer: Multiplan Commercial |
$513.60
|
| Rate for Payer: Networks By Design Commercial |
$417.30
|
| Rate for Payer: Prime Health Services Commercial |
$545.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$385.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$385.20
|
| 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 |
$545.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$545.70
|
| Rate for Payer: Vantage Medical Group Senior |
$545.70
|
|
|
HC EVAL SPEECH SOUND PROD W LANG COMP EXPRES
|
Facility
|
IP
|
$642.00
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
900100002
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$128.40 |
| Max. Negotiated Rate |
$545.70 |
| Rate for Payer: Adventist Health Commercial |
$128.40
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.80
|
| Rate for Payer: EPIC Health Plan Senior |
$256.80
|
| Rate for Payer: Galaxy Health WC |
$545.70
|
| Rate for Payer: Global Benefits Group Commercial |
$385.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$428.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$244.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$397.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.08
|
| Rate for Payer: Multiplan Commercial |
$513.60
|
| Rate for Payer: Networks By Design Commercial |
$417.30
|
| Rate for Payer: Prime Health Services Commercial |
$545.70
|
|
|
HC EVAL SPEECH SOUND PROD W LANG COMP EXPRES
|
Facility
|
OP
|
$642.00
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
900100002
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$154.08 |
| Max. Negotiated Rate |
$545.70 |
| Rate for Payer: Adventist Health Commercial |
$263.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$421.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$545.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$353.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$481.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cash Price |
$353.10
|
| Rate for Payer: Cigna of CA HMO |
$410.88
|
| Rate for Payer: Cigna of CA PPO |
$475.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$545.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$545.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$545.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$256.80
|
| Rate for Payer: EPIC Health Plan Senior |
$256.80
|
| Rate for Payer: Galaxy Health WC |
$545.70
|
| Rate for Payer: Global Benefits Group Commercial |
$385.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$219.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$428.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$248.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$397.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$449.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$449.40
|
| Rate for Payer: Multiplan Commercial |
$513.60
|
| Rate for Payer: Networks By Design Commercial |
$417.30
|
| Rate for Payer: Prime Health Services Commercial |
$545.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$385.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$385.20
|
| 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 |
$545.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$545.70
|
| Rate for Payer: Vantage Medical Group Senior |
$545.70
|
|
|
HC EVAL SWALLOW/ORAL FUNC
|
Facility
|
IP
|
$818.00
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
905601753
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$163.60 |
| Max. Negotiated Rate |
$695.30 |
| Rate for Payer: Adventist Health Commercial |
$163.60
|
| Rate for Payer: Cash Price |
$449.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$327.20
|
| Rate for Payer: EPIC Health Plan Senior |
$327.20
|
| Rate for Payer: Galaxy Health WC |
$695.30
|
| Rate for Payer: Global Benefits Group Commercial |
$490.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$545.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$311.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$506.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.32
|
| Rate for Payer: Multiplan Commercial |
$654.40
|
| Rate for Payer: Networks By Design Commercial |
$531.70
|
| Rate for Payer: Prime Health Services Commercial |
$695.30
|
|
|
HC EVAL SWALLOW/ORAL FUNC
|
Facility
|
OP
|
$818.00
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
905601753
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$81.95 |
| Max. Negotiated Rate |
$695.30 |
| Rate for Payer: Adventist Health Commercial |
$335.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$536.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$695.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$449.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$613.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$449.90
|
| Rate for Payer: Cash Price |
$449.90
|
| Rate for Payer: Cash Price |
$449.90
|
| Rate for Payer: Cash Price |
$449.90
|
| Rate for Payer: Cigna of CA HMO |
$523.52
|
| Rate for Payer: Cigna of CA PPO |
$605.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$695.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$695.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$695.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$327.20
|
| Rate for Payer: EPIC Health Plan Senior |
$327.20
|
| Rate for Payer: Galaxy Health WC |
$695.30
|
| Rate for Payer: Global Benefits Group Commercial |
$490.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$81.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$545.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$506.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$572.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$572.60
|
| Rate for Payer: Multiplan Commercial |
$654.40
|
| Rate for Payer: Networks By Design Commercial |
$531.70
|
| Rate for Payer: Prime Health Services Commercial |
$695.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$490.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$490.80
|
| 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 |
$695.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$695.30
|
| Rate for Payer: Vantage Medical Group Senior |
$695.30
|
|
|
HC EVAL SWALLOW/ORAL FUNC MCAL
|
Facility
|
OP
|
$818.00
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
907000023
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$81.95 |
| Max. Negotiated Rate |
$695.30 |
| Rate for Payer: Adventist Health Commercial |
$335.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$536.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$695.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$449.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$613.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$449.90
|
| Rate for Payer: Cash Price |
$449.90
|
| Rate for Payer: Cash Price |
$449.90
|
| Rate for Payer: Cash Price |
$449.90
|
| Rate for Payer: Cigna of CA HMO |
$523.52
|
| Rate for Payer: Cigna of CA PPO |
$605.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$695.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$695.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$695.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$327.20
|
| Rate for Payer: EPIC Health Plan Senior |
$327.20
|
| Rate for Payer: Galaxy Health WC |
$695.30
|
| Rate for Payer: Global Benefits Group Commercial |
$490.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$81.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$545.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$506.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$572.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$572.60
|
| Rate for Payer: Multiplan Commercial |
$654.40
|
| Rate for Payer: Networks By Design Commercial |
$531.70
|
| Rate for Payer: Prime Health Services Commercial |
$695.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$490.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$490.80
|
| 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 |
$695.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$695.30
|
| Rate for Payer: Vantage Medical Group Senior |
$695.30
|
|
|
HC EVAL SWALLOW/ORAL FUNC MCAL
|
Facility
|
IP
|
$818.00
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
907000023
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$163.60 |
| Max. Negotiated Rate |
$695.30 |
| Rate for Payer: Adventist Health Commercial |
$163.60
|
| Rate for Payer: Cash Price |
$449.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$327.20
|
| Rate for Payer: EPIC Health Plan Senior |
$327.20
|
| Rate for Payer: Galaxy Health WC |
$695.30
|
| Rate for Payer: Global Benefits Group Commercial |
$490.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$545.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$311.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$506.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$196.32
|
| Rate for Payer: Multiplan Commercial |
$654.40
|
| Rate for Payer: Networks By Design Commercial |
$531.70
|
| Rate for Payer: Prime Health Services Commercial |
$695.30
|
|
|
HC EVAL SWALLOW W RADIOLOGY MCAL
|
Facility
|
OP
|
$989.00
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
907000022
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$67.12 |
| Max. Negotiated Rate |
$840.65 |
| Rate for Payer: Adventist Health Commercial |
$405.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$648.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$840.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$543.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$741.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: Cigna of CA HMO |
$632.96
|
| Rate for Payer: Cigna of CA PPO |
$731.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$840.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$840.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$840.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$67.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$75.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$692.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$692.30
|
| Rate for Payer: Multiplan Commercial |
$791.20
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$593.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$593.40
|
| 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 |
$840.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$840.65
|
| Rate for Payer: Vantage Medical Group Senior |
$840.65
|
|
|
HC EVAL SWALLOW W RADIOLOGY MCAL
|
Facility
|
IP
|
$989.00
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
907000022
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$197.80 |
| Max. Negotiated Rate |
$840.65 |
| Rate for Payer: Adventist Health Commercial |
$197.80
|
| Rate for Payer: Cash Price |
$543.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$395.60
|
| Rate for Payer: EPIC Health Plan Senior |
$395.60
|
| Rate for Payer: Galaxy Health WC |
$840.65
|
| Rate for Payer: Global Benefits Group Commercial |
$593.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$659.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$376.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$612.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$237.36
|
| Rate for Payer: Multiplan Commercial |
$791.20
|
| Rate for Payer: Networks By Design Commercial |
$642.85
|
| Rate for Payer: Prime Health Services Commercial |
$840.65
|
|
|
HC EVAL VOICE/AUG COMM DVC
|
Facility
|
IP
|
$711.00
|
|
|
Service Code
|
CPT 92597
|
| Hospital Charge Code |
905601812
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$142.20 |
| Max. Negotiated Rate |
$604.35 |
| Rate for Payer: Adventist Health Commercial |
$142.20
|
| Rate for Payer: Cash Price |
$391.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$284.40
|
| Rate for Payer: EPIC Health Plan Senior |
$284.40
|
| Rate for Payer: Galaxy Health WC |
$604.35
|
| Rate for Payer: Global Benefits Group Commercial |
$426.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$474.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$270.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$440.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.64
|
| Rate for Payer: Multiplan Commercial |
$568.80
|
| Rate for Payer: Networks By Design Commercial |
$462.15
|
| Rate for Payer: Prime Health Services Commercial |
$604.35
|
|
|
HC EVAL VOICE/AUG COMM DVC
|
Facility
|
OP
|
$711.00
|
|
|
Service Code
|
CPT 92597
|
| Hospital Charge Code |
905601812
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$137.58 |
| Max. Negotiated Rate |
$604.35 |
| Rate for Payer: Adventist Health Commercial |
$291.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$466.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$604.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$391.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$533.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$457.00
|
| Rate for Payer: Blue Shield of California Commercial |
$421.00
|
| Rate for Payer: Blue Shield of California EPN |
$279.00
|
| Rate for Payer: Cash Price |
$391.05
|
| Rate for Payer: Cash Price |
$391.05
|
| Rate for Payer: Cash Price |
$391.05
|
| Rate for Payer: Cash Price |
$391.05
|
| Rate for Payer: Cigna of CA HMO |
$455.04
|
| Rate for Payer: Cigna of CA PPO |
$526.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$604.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$604.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$604.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$284.40
|
| Rate for Payer: EPIC Health Plan Senior |
$284.40
|
| Rate for Payer: Galaxy Health WC |
$604.35
|
| Rate for Payer: Global Benefits Group Commercial |
$426.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$137.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$474.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$440.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$170.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$497.70
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$497.70
|
| Rate for Payer: Multiplan Commercial |
$568.80
|
| Rate for Payer: Networks By Design Commercial |
$462.15
|
| Rate for Payer: Prime Health Services Commercial |
$604.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$426.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$426.60
|
| 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 |
$604.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$604.35
|
| Rate for Payer: Vantage Medical Group Senior |
$604.35
|
|
