|
HC SUTURE VICRYL 9-0 BRAIDED 12IN
|
Facility
|
IP
|
$90.90
|
|
| Hospital Charge Code |
901698854
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$18.18 |
| Max. Negotiated Rate |
$81.81 |
| Rate for Payer: Adventist Health Commercial |
$18.18
|
| Rate for Payer: Cash Price |
$40.90
|
| Rate for Payer: Central Health Plan Commercial |
$72.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$63.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.36
|
| Rate for Payer: EPIC Health Plan Senior |
$36.36
|
| Rate for Payer: Galaxy Health WC |
$77.27
|
| Rate for Payer: Global Benefits Group Commercial |
$54.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$81.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$57.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$53.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$18.18
|
| Rate for Payer: Multiplan Commercial |
$68.17
|
| Rate for Payer: Networks By Design Commercial |
$59.09
|
| Rate for Payer: Prime Health Services Commercial |
$77.27
|
|
|
HC SUTURE VICRYL+ANTIBAC 210331
|
Facility
|
IP
|
$15.50
|
|
| Hospital Charge Code |
901693106
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$13.95 |
| Rate for Payer: Adventist Health Commercial |
$3.10
|
| Rate for Payer: Cash Price |
$6.98
|
| Rate for Payer: Central Health Plan Commercial |
$12.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6.20
|
| Rate for Payer: Galaxy Health WC |
$13.18
|
| Rate for Payer: Global Benefits Group Commercial |
$9.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.10
|
| Rate for Payer: Multiplan Commercial |
$11.62
|
| Rate for Payer: Networks By Design Commercial |
$10.07
|
| Rate for Payer: Prime Health Services Commercial |
$13.18
|
|
|
HC SUTURE VICRYL+ANTIBAC 210331
|
Facility
|
OP
|
$15.50
|
|
| Hospital Charge Code |
901693106
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$13.95 |
| Rate for Payer: Adventist Health Commercial |
$3.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.02
|
| Rate for Payer: Blue Shield of California Commercial |
$9.83
|
| Rate for Payer: Blue Shield of California EPN |
$6.18
|
| Rate for Payer: Cash Price |
$6.98
|
| Rate for Payer: Central Health Plan Commercial |
$12.40
|
| Rate for Payer: Cigna of CA HMO |
$9.92
|
| Rate for Payer: Cigna of CA PPO |
$11.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.20
|
| Rate for Payer: EPIC Health Plan Senior |
$6.20
|
| Rate for Payer: Galaxy Health WC |
$13.18
|
| Rate for Payer: Global Benefits Group Commercial |
$9.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.85
|
| Rate for Payer: Multiplan Commercial |
$11.62
|
| Rate for Payer: Networks By Design Commercial |
$10.07
|
| Rate for Payer: Prime Health Services Commercial |
$13.18
|
| Rate for Payer: Riverside University Health System MISP |
$6.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.75
|
| Rate for Payer: United Healthcare All Other HMO |
$7.75
|
| Rate for Payer: United Healthcare HMO Rider |
$7.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.18
|
| Rate for Payer: Vantage Medical Group Senior |
$13.18
|
|
|
HC SUTURE VICRYL+ ATBC 1-0 27"
|
Facility
|
OP
|
$15.83
|
|
| Hospital Charge Code |
901693107
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: Adventist Health Commercial |
$3.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.61
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.21
|
| Rate for Payer: Blue Shield of California Commercial |
$10.04
|
| Rate for Payer: Blue Shield of California EPN |
$6.32
|
| Rate for Payer: Cash Price |
$7.12
|
| Rate for Payer: Central Health Plan Commercial |
$12.66
|
| Rate for Payer: Cigna of CA HMO |
$10.13
|
| Rate for Payer: Cigna of CA PPO |
$11.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.33
|
| Rate for Payer: EPIC Health Plan Senior |
$6.33
|
| Rate for Payer: Galaxy Health WC |
$13.46
|
| Rate for Payer: Global Benefits Group Commercial |
$9.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.08
|
| Rate for Payer: Multiplan Commercial |
$11.87
|
| Rate for Payer: Networks By Design Commercial |
$10.29
|
| Rate for Payer: Prime Health Services Commercial |
$13.46
|
| Rate for Payer: Riverside University Health System MISP |
$6.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.92
|
| Rate for Payer: United Healthcare All Other HMO |
$7.92
|
| Rate for Payer: United Healthcare HMO Rider |
$7.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.46
|
| Rate for Payer: Vantage Medical Group Senior |
$13.46
|
|
|
HC SUTURE VICRYL+ ATBC 1-0 27"
|
Facility
|
IP
|
$15.83
|
|
| Hospital Charge Code |
901693107
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$14.25 |
| Rate for Payer: Adventist Health Commercial |
$3.17
|
| Rate for Payer: Cash Price |
$7.12
|
| Rate for Payer: Central Health Plan Commercial |
$12.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.33
|
| Rate for Payer: EPIC Health Plan Senior |
$6.33
|
| Rate for Payer: Galaxy Health WC |
$13.46
|
| Rate for Payer: Global Benefits Group Commercial |
$9.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.17
|
| Rate for Payer: Multiplan Commercial |
$11.87
|
| Rate for Payer: Networks By Design Commercial |
$10.29
|
| Rate for Payer: Prime Health Services Commercial |
$13.46
|
|
|
HC SUTURE VICRYL PLUS 0
|
Facility
|
OP
|
$14.55
|
|
| Hospital Charge Code |
901695000
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$13.10 |
| Rate for Payer: Adventist Health Commercial |
$2.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.46
|
| Rate for Payer: Blue Shield of California Commercial |
$9.22
|
| Rate for Payer: Blue Shield of California EPN |
$5.81
|
| Rate for Payer: Cash Price |
$6.55
|
| Rate for Payer: Central Health Plan Commercial |
$11.64
|
| Rate for Payer: Cigna of CA HMO |
$9.31
|
| Rate for Payer: Cigna of CA PPO |
$10.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.82
|
| Rate for Payer: EPIC Health Plan Senior |
$5.82
|
| Rate for Payer: Galaxy Health WC |
$12.37
|
| Rate for Payer: Global Benefits Group Commercial |
$8.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.19
|
| Rate for Payer: Multiplan Commercial |
$10.91
|
| Rate for Payer: Networks By Design Commercial |
$9.46
|
| Rate for Payer: Prime Health Services Commercial |
$12.37
|
| Rate for Payer: Riverside University Health System MISP |
$5.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.28
|
| Rate for Payer: United Healthcare All Other HMO |
$7.28
|
| Rate for Payer: United Healthcare HMO Rider |
$7.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.37
|
| Rate for Payer: Vantage Medical Group Senior |
$12.37
|
|
|
HC SUTURE VICRYL PLUS 0
|
Facility
|
IP
|
$14.55
|
|
| Hospital Charge Code |
901695000
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$13.10 |
| Rate for Payer: Adventist Health Commercial |
$2.91
|
| Rate for Payer: Cash Price |
$6.55
|
| Rate for Payer: Central Health Plan Commercial |
$11.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.82
|
| Rate for Payer: EPIC Health Plan Senior |
$5.82
|
| Rate for Payer: Galaxy Health WC |
$12.37
|
| Rate for Payer: Global Benefits Group Commercial |
$8.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.91
|
| Rate for Payer: Multiplan Commercial |
$10.91
|
| Rate for Payer: Networks By Design Commercial |
$9.46
|
| Rate for Payer: Prime Health Services Commercial |
$12.37
|
|
|
HC SUTURE VICRYL PLUS 3-0 SH
|
Facility
|
OP
|
$155.89
|
|
| Hospital Charge Code |
901694887
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.18 |
| Max. Negotiated Rate |
$140.30 |
| Rate for Payer: Adventist Health Commercial |
$31.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$94.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$132.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$85.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$116.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$75.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$90.68
|
| Rate for Payer: Blue Shield of California Commercial |
$98.83
|
| Rate for Payer: Blue Shield of California EPN |
$62.20
|
| Rate for Payer: Cash Price |
$70.15
|
| Rate for Payer: Central Health Plan Commercial |
$124.71
|
| Rate for Payer: Cigna of CA HMO |
$99.77
|
| Rate for Payer: Cigna of CA PPO |
$115.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$132.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$132.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$132.51
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$109.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.36
|
| Rate for Payer: EPIC Health Plan Senior |
$62.36
|
| Rate for Payer: Galaxy Health WC |
$132.51
|
| Rate for Payer: Global Benefits Group Commercial |
$93.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$140.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$98.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$91.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$109.12
|
| Rate for Payer: Multiplan Commercial |
$116.92
|
| Rate for Payer: Networks By Design Commercial |
$101.33
|
| Rate for Payer: Prime Health Services Commercial |
$132.51
|
| Rate for Payer: Riverside University Health System MISP |
$62.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$93.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$93.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$77.94
|
| Rate for Payer: United Healthcare All Other HMO |
$77.94
|
| Rate for Payer: United Healthcare HMO Rider |
$77.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$77.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$132.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$132.51
|
| Rate for Payer: Vantage Medical Group Senior |
$132.51
|
|
|
HC SUTURE VICRYL PLUS 3-0 SH
|
Facility
|
IP
|
$155.89
|
|
| Hospital Charge Code |
901694887
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$31.18 |
| Max. Negotiated Rate |
$140.30 |
| Rate for Payer: Adventist Health Commercial |
$31.18
|
| Rate for Payer: Cash Price |
$70.15
|
| Rate for Payer: Central Health Plan Commercial |
$124.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$109.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$62.36
|
| Rate for Payer: EPIC Health Plan Senior |
$62.36
|
| Rate for Payer: Galaxy Health WC |
$132.51
|
| Rate for Payer: Global Benefits Group Commercial |
$93.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$140.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$98.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$91.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.18
|
| Rate for Payer: Multiplan Commercial |
$116.92
|
| Rate for Payer: Networks By Design Commercial |
$101.33
|
| Rate for Payer: Prime Health Services Commercial |
$132.51
|
|
|
HC SUTURE VICRYL RAPIDE 3-0 CT-1
|
Facility
|
IP
|
$32.47
|
|
| Hospital Charge Code |
901694881
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$29.22 |
| Rate for Payer: Adventist Health Commercial |
$6.49
|
| Rate for Payer: Cash Price |
$14.61
|
| Rate for Payer: Central Health Plan Commercial |
$25.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.99
|
| Rate for Payer: EPIC Health Plan Senior |
$12.99
|
| Rate for Payer: Galaxy Health WC |
$27.60
|
| Rate for Payer: Global Benefits Group Commercial |
$19.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.49
|
| Rate for Payer: Multiplan Commercial |
$24.35
|
| Rate for Payer: Networks By Design Commercial |
$21.11
|
| Rate for Payer: Prime Health Services Commercial |
$27.60
|
|
|
HC SUTURE VICRYL RAPIDE 3-0 CT-1
|
Facility
|
OP
|
$32.47
|
|
| Hospital Charge Code |
901694881
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$29.22 |
| Rate for Payer: Adventist Health Commercial |
$6.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.89
|
| Rate for Payer: Blue Shield of California Commercial |
$20.59
|
| Rate for Payer: Blue Shield of California EPN |
$12.96
|
| Rate for Payer: Cash Price |
$14.61
|
| Rate for Payer: Central Health Plan Commercial |
$25.98
|
| Rate for Payer: Cigna of CA HMO |
$20.78
|
| Rate for Payer: Cigna of CA PPO |
$24.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.99
|
| Rate for Payer: EPIC Health Plan Senior |
$12.99
|
| Rate for Payer: Galaxy Health WC |
$27.60
|
| Rate for Payer: Global Benefits Group Commercial |
$19.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.73
|
| Rate for Payer: Multiplan Commercial |
$24.35
|
| Rate for Payer: Networks By Design Commercial |
$21.11
|
| Rate for Payer: Prime Health Services Commercial |
$27.60
|
| Rate for Payer: Riverside University Health System MISP |
$12.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.23
|
| Rate for Payer: United Healthcare All Other HMO |
$16.23
|
| Rate for Payer: United Healthcare HMO Rider |
$16.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.60
|
| Rate for Payer: Vantage Medical Group Senior |
$27.60
|
|
|
HC SVC ANGER-PROBLEM SOLVING
|
Facility
|
OP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804017
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Adventist Health Commercial |
$74.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$130.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$181.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$217.56
|
| Rate for Payer: Blue Shield of California Commercial |
$237.12
|
| Rate for Payer: Blue Shield of California EPN |
$149.23
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Central Health Plan Commercial |
$299.20
|
| Rate for Payer: Cigna of CA HMO |
$239.36
|
| Rate for Payer: Cigna of CA PPO |
$276.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$317.90
|
| Rate for Payer: Global Benefits Group Commercial |
$224.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.60
|
| Rate for Payer: Health Net Behavioral |
$800.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$214.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$130.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.08
|
| Rate for Payer: Multiplan Commercial |
$280.50
|
| Rate for Payer: Networks By Design Commercial |
$243.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$317.90
|
| Rate for Payer: Prime Health Services Medicare |
$138.50
|
| Rate for Payer: Riverside University Health System MISP |
$143.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.40
|
| Rate for Payer: Upland Medical Group Pediatric |
$130.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC SVC ANGER-PROBLEM SOLVING
|
Facility
|
IP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804017
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$74.80 |
| Max. Negotiated Rate |
$336.60 |
| Rate for Payer: Adventist Health Commercial |
$74.80
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Central Health Plan Commercial |
$299.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.60
|
| Rate for Payer: EPIC Health Plan Senior |
$149.60
|
| Rate for Payer: Galaxy Health WC |
$317.90
|
| Rate for Payer: Global Benefits Group Commercial |
$224.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.66
|
| Rate for Payer: Multiplan Commercial |
$280.50
|
| Rate for Payer: Networks By Design Commercial |
$243.10
|
| Rate for Payer: Prime Health Services Commercial |
$317.90
|
|
|
HC SVC COPING SKILLS
|
Facility
|
OP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804014
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Adventist Health Commercial |
$74.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$130.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$181.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$217.56
|
| Rate for Payer: Blue Shield of California Commercial |
$237.12
|
| Rate for Payer: Blue Shield of California EPN |
$149.23
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Central Health Plan Commercial |
$299.20
|
| Rate for Payer: Cigna of CA HMO |
$239.36
|
| Rate for Payer: Cigna of CA PPO |
$276.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$317.90
|
| Rate for Payer: Global Benefits Group Commercial |
$224.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.60
|
| Rate for Payer: Health Net Behavioral |
$800.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$214.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$130.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.08
|
| Rate for Payer: Multiplan Commercial |
$280.50
|
| Rate for Payer: Networks By Design Commercial |
$243.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$317.90
|
| Rate for Payer: Prime Health Services Medicare |
$138.50
|
| Rate for Payer: Riverside University Health System MISP |
$143.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.40
|
| Rate for Payer: Upland Medical Group Pediatric |
$130.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC SVC COPING SKILLS
|
Facility
|
IP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804014
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$74.80 |
| Max. Negotiated Rate |
$336.60 |
| Rate for Payer: Adventist Health Commercial |
$74.80
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Central Health Plan Commercial |
$299.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.60
|
| Rate for Payer: EPIC Health Plan Senior |
$149.60
|
| Rate for Payer: Galaxy Health WC |
$317.90
|
| Rate for Payer: Global Benefits Group Commercial |
$224.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.66
|
| Rate for Payer: Multiplan Commercial |
$280.50
|
| Rate for Payer: Networks By Design Commercial |
$243.10
|
| Rate for Payer: Prime Health Services Commercial |
$317.90
|
|
|
HC SVC ED HEALTH EDUCATION
|
Facility
|
OP
|
$385.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804107
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Adventist Health Commercial |
$77.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$130.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$186.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$223.95
|
| Rate for Payer: Blue Shield of California Commercial |
$244.09
|
| Rate for Payer: Blue Shield of California EPN |
$153.62
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Central Health Plan Commercial |
$308.00
|
| Rate for Payer: Cigna of CA HMO |
$246.40
|
| Rate for Payer: Cigna of CA PPO |
$284.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$269.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$327.25
|
| Rate for Payer: Global Benefits Group Commercial |
$231.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$346.50
|
| Rate for Payer: Health Net Behavioral |
$800.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$214.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$130.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$244.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.08
|
| Rate for Payer: Multiplan Commercial |
$288.75
|
| Rate for Payer: Networks By Design Commercial |
$250.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$327.25
|
| Rate for Payer: Prime Health Services Medicare |
$138.50
|
| Rate for Payer: Riverside University Health System MISP |
$143.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$231.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$231.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$130.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC SVC ED HEALTH EDUCATION
|
Facility
|
IP
|
$385.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804107
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$346.50 |
| Rate for Payer: Adventist Health Commercial |
$77.00
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Central Health Plan Commercial |
$308.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$269.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.00
|
| Rate for Payer: EPIC Health Plan Senior |
$154.00
|
| Rate for Payer: Galaxy Health WC |
$327.25
|
| Rate for Payer: Global Benefits Group Commercial |
$231.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$346.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$244.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$227.15
|
| Rate for Payer: Multiplan Commercial |
$288.75
|
| Rate for Payer: Networks By Design Commercial |
$250.25
|
| Rate for Payer: Prime Health Services Commercial |
$327.25
|
|
|
HC SVC ED MENTAL HEALTH EDUCATION
|
Facility
|
OP
|
$385.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804106
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Adventist Health Commercial |
$77.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$130.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$186.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$223.95
|
| Rate for Payer: Blue Shield of California Commercial |
$244.09
|
| Rate for Payer: Blue Shield of California EPN |
$153.62
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Central Health Plan Commercial |
$308.00
|
| Rate for Payer: Cigna of CA HMO |
$246.40
|
| Rate for Payer: Cigna of CA PPO |
$284.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$269.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$327.25
|
| Rate for Payer: Global Benefits Group Commercial |
$231.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$346.50
|
| Rate for Payer: Health Net Behavioral |
$800.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$214.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$130.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$244.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.08
|
| Rate for Payer: Multiplan Commercial |
$288.75
|
| Rate for Payer: Networks By Design Commercial |
$250.25
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$327.25
|
| Rate for Payer: Prime Health Services Medicare |
$138.50
|
| Rate for Payer: Riverside University Health System MISP |
$143.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$231.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$231.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$130.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC SVC ED MENTAL HEALTH EDUCATION
|
Facility
|
IP
|
$385.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804106
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$77.00 |
| Max. Negotiated Rate |
$346.50 |
| Rate for Payer: Adventist Health Commercial |
$77.00
|
| Rate for Payer: Cash Price |
$173.25
|
| Rate for Payer: Central Health Plan Commercial |
$308.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$269.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$154.00
|
| Rate for Payer: EPIC Health Plan Senior |
$154.00
|
| Rate for Payer: Galaxy Health WC |
$327.25
|
| Rate for Payer: Global Benefits Group Commercial |
$231.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$346.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$244.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$227.15
|
| Rate for Payer: Multiplan Commercial |
$288.75
|
| Rate for Payer: Networks By Design Commercial |
$250.25
|
| Rate for Payer: Prime Health Services Commercial |
$327.25
|
|
|
HC SVC ED STRESS MANAGEMENT
|
Facility
|
IP
|
$402.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804108
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$361.80 |
| Rate for Payer: Adventist Health Commercial |
$80.40
|
| Rate for Payer: Cash Price |
$180.90
|
| Rate for Payer: Central Health Plan Commercial |
$321.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$281.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$160.80
|
| Rate for Payer: EPIC Health Plan Senior |
$160.80
|
| Rate for Payer: Galaxy Health WC |
$341.70
|
| Rate for Payer: Global Benefits Group Commercial |
$241.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$361.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$255.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$237.18
|
| Rate for Payer: Multiplan Commercial |
$301.50
|
| Rate for Payer: Networks By Design Commercial |
$261.30
|
| Rate for Payer: Prime Health Services Commercial |
$341.70
|
|
|
HC SVC ED STRESS MANAGEMENT
|
Facility
|
OP
|
$402.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804108
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Adventist Health Commercial |
$80.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$228.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$674.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$342.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$228.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$194.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$233.84
|
| Rate for Payer: Blue Shield of California Commercial |
$254.87
|
| Rate for Payer: Blue Shield of California EPN |
$160.40
|
| Rate for Payer: Cash Price |
$180.90
|
| Rate for Payer: Cash Price |
$180.90
|
| Rate for Payer: Cash Price |
$180.90
|
| Rate for Payer: Central Health Plan Commercial |
$321.60
|
| Rate for Payer: Cigna of CA HMO |
$257.28
|
| Rate for Payer: Cigna of CA PPO |
$297.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$342.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$228.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$281.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.68
|
| Rate for Payer: EPIC Health Plan Senior |
$251.12
|
| Rate for Payer: Galaxy Health WC |
$341.70
|
| Rate for Payer: Global Benefits Group Commercial |
$241.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$361.80
|
| Rate for Payer: Health Net Behavioral |
$800.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$374.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$115.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$228.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$255.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$319.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$305.91
|
| Rate for Payer: Multiplan Commercial |
$301.50
|
| Rate for Payer: Networks By Design Commercial |
$261.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$228.29
|
| Rate for Payer: Prime Health Services Commercial |
$341.70
|
| Rate for Payer: Prime Health Services Medicare |
$241.99
|
| Rate for Payer: Riverside University Health System MISP |
$251.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$241.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$241.20
|
| Rate for Payer: Upland Medical Group Pediatric |
$228.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$342.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$228.29
|
|
|
HC SVC HEALTH EDUCATION
|
Facility
|
IP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804013
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$74.80 |
| Max. Negotiated Rate |
$336.60 |
| Rate for Payer: Adventist Health Commercial |
$74.80
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Central Health Plan Commercial |
$299.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.60
|
| Rate for Payer: EPIC Health Plan Senior |
$149.60
|
| Rate for Payer: Galaxy Health WC |
$317.90
|
| Rate for Payer: Global Benefits Group Commercial |
$224.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.66
|
| Rate for Payer: Multiplan Commercial |
$280.50
|
| Rate for Payer: Networks By Design Commercial |
$243.10
|
| Rate for Payer: Prime Health Services Commercial |
$317.90
|
|
|
HC SVC HEALTH EDUCATION
|
Facility
|
OP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804013
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Adventist Health Commercial |
$74.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$130.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$251.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$130.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$181.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$217.56
|
| Rate for Payer: Blue Shield of California Commercial |
$237.12
|
| Rate for Payer: Blue Shield of California EPN |
$149.23
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Cash Price |
$168.30
|
| Rate for Payer: Central Health Plan Commercial |
$299.20
|
| Rate for Payer: Cigna of CA HMO |
$239.36
|
| Rate for Payer: Cigna of CA PPO |
$276.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$195.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$143.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$130.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$317.90
|
| Rate for Payer: Global Benefits Group Commercial |
$224.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.60
|
| Rate for Payer: Health Net Behavioral |
$800.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$214.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$41.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$130.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$45.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$182.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$175.08
|
| Rate for Payer: Multiplan Commercial |
$280.50
|
| Rate for Payer: Networks By Design Commercial |
$243.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$317.90
|
| Rate for Payer: Prime Health Services Medicare |
$138.50
|
| Rate for Payer: Riverside University Health System MISP |
$143.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.40
|
| Rate for Payer: Upland Medical Group Pediatric |
$130.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$195.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$143.73
|
| Rate for Payer: Vantage Medical Group Senior |
$130.66
|
|
|
HC SVC LIFE-PROBLEM SOLVING
|
Facility
|
OP
|
$262.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804016
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Adventist Health Commercial |
$52.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$228.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$674.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$342.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$251.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$228.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$126.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152.41
|
| Rate for Payer: Blue Shield of California Commercial |
$166.11
|
| Rate for Payer: Blue Shield of California EPN |
$104.54
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Central Health Plan Commercial |
$209.60
|
| Rate for Payer: Cigna of CA HMO |
$167.68
|
| Rate for Payer: Cigna of CA PPO |
$193.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$342.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$251.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$228.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$183.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.68
|
| Rate for Payer: EPIC Health Plan Senior |
$251.12
|
| Rate for Payer: Galaxy Health WC |
$222.70
|
| Rate for Payer: Global Benefits Group Commercial |
$157.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$235.80
|
| Rate for Payer: Health Net Behavioral |
$800.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$374.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$115.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$228.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$166.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$127.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$319.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$305.91
|
| Rate for Payer: Multiplan Commercial |
$196.50
|
| Rate for Payer: Networks By Design Commercial |
$170.30
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$228.29
|
| Rate for Payer: Prime Health Services Commercial |
$222.70
|
| Rate for Payer: Prime Health Services Medicare |
$241.99
|
| Rate for Payer: Riverside University Health System MISP |
$251.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$157.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$157.20
|
| Rate for Payer: Upland Medical Group Pediatric |
$228.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$342.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$251.12
|
| Rate for Payer: Vantage Medical Group Senior |
$228.29
|
|
|
HC SVC LIFE-PROBLEM SOLVING
|
Facility
|
IP
|
$262.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804016
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$52.40 |
| Max. Negotiated Rate |
$235.80 |
| Rate for Payer: Adventist Health Commercial |
$52.40
|
| Rate for Payer: Cash Price |
$117.90
|
| Rate for Payer: Central Health Plan Commercial |
$209.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$183.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.80
|
| Rate for Payer: EPIC Health Plan Senior |
$104.80
|
| Rate for Payer: Galaxy Health WC |
$222.70
|
| Rate for Payer: Global Benefits Group Commercial |
$157.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$235.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$166.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$154.58
|
| Rate for Payer: Multiplan Commercial |
$196.50
|
| Rate for Payer: Networks By Design Commercial |
$170.30
|
| Rate for Payer: Prime Health Services Commercial |
$222.70
|
|
