|
HC TRIM SKIN LESION, SINGLE
|
Facility
|
OP
|
$544.00
|
|
|
Service Code
|
CPT 11055
|
| Hospital Charge Code |
902890267
|
|
Hospital Revenue Code
|
456
|
| Min. Negotiated Rate |
$31.82 |
| Max. Negotiated Rate |
$1,833.00 |
| Rate for Payer: Adventist Health Commercial |
$223.04
|
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$258.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$316.44
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$402.27
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Cash Price |
$244.80
|
| Rate for Payer: Central Health Plan Commercial |
$435.20
|
| Rate for Payer: Cigna of CA HMO |
$348.16
|
| Rate for Payer: Cigna of CA PPO |
$402.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$387.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$283.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$258.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$380.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$425.78
|
| Rate for Payer: EPIC Health Plan Senior |
$283.86
|
| Rate for Payer: Galaxy Health WC |
$462.40
|
| Rate for Payer: Global Benefits Group Commercial |
$326.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$489.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$423.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$973.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$258.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$345.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$31.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$277.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$108.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$345.79
|
| Rate for Payer: Multiplan Commercial |
$408.00
|
| Rate for Payer: Multiplan WC |
$402.27
|
| Rate for Payer: Networks By Design Commercial |
$353.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$258.05
|
| Rate for Payer: Preferred Health Network WC |
$410.48
|
| Rate for Payer: Prime Health Services Commercial |
$462.40
|
| Rate for Payer: Prime Health Services Medicare |
$273.53
|
| Rate for Payer: Prime Health Services WC |
$398.17
|
| Rate for Payer: Riverside University Health System MISP |
$283.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$326.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$326.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$796.00
|
| Rate for Payer: United Healthcare All Other HMO |
$608.00
|
| Rate for Payer: United Healthcare HMO Rider |
$480.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$440.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$258.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$387.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$283.86
|
| Rate for Payer: Vantage Medical Group Senior |
$258.05
|
|
|
HC TRLUML BLLN ANGIO ADDL ART
|
Facility
|
OP
|
$10,548.00
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
909037247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,000.00 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,109.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,965.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,801.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,911.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$4,746.60
|
| Rate for Payer: Cash Price |
$4,746.60
|
| Rate for Payer: Cash Price |
$4,746.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,438.40
|
| Rate for Payer: Cigna of CA HMO |
$6,750.72
|
| Rate for Payer: Cigna of CA PPO |
$7,805.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,965.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,965.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,965.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,383.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,219.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,219.20
|
| Rate for Payer: Galaxy Health WC |
$8,965.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,328.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,493.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,358.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,697.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,500.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,223.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,109.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7,383.60
|
| Rate for Payer: Multiplan Commercial |
$7,911.00
|
| Rate for Payer: Networks By Design Commercial |
$6,856.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,965.80
|
| Rate for Payer: Riverside University Health System MISP |
$4,219.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,328.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,274.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,965.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,965.80
|
| Rate for Payer: Vantage Medical Group Senior |
$8,965.80
|
|
|
HC TRLUML BLLN ANGIO ADDL ART
|
Facility
|
IP
|
$10,548.00
|
|
|
Service Code
|
CPT 37247
|
| Hospital Charge Code |
909037247
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,109.60 |
| Max. Negotiated Rate |
$9,493.20 |
| Rate for Payer: Adventist Health Commercial |
$2,109.60
|
| Rate for Payer: Cash Price |
$4,746.60
|
| Rate for Payer: Central Health Plan Commercial |
$8,438.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,383.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,219.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,219.20
|
| Rate for Payer: Galaxy Health WC |
$8,965.80
|
| Rate for Payer: Global Benefits Group Commercial |
$6,328.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,493.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,697.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,223.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,109.60
|
| Rate for Payer: Multiplan Commercial |
$7,911.00
|
| Rate for Payer: Networks By Design Commercial |
$6,856.20
|
| Rate for Payer: Prime Health Services Commercial |
$8,965.80
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
|
OP
|
$10,303.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
909037249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$992.56 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Commercial |
$2,060.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8,757.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5,666.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,727.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Blue Shield of California Commercial |
$8,136.21
|
| Rate for Payer: Blue Shield of California EPN |
$5,113.68
|
| Rate for Payer: Cash Price |
$4,636.35
|
| Rate for Payer: Cash Price |
$4,636.35
|
| Rate for Payer: Cash Price |
$4,636.35
|
| Rate for Payer: Central Health Plan Commercial |
$8,242.40
|
| Rate for Payer: Cigna of CA HMO |
$6,593.92
|
| Rate for Payer: Cigna of CA PPO |
$7,624.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8,757.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,757.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8,757.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,212.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,121.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,121.20
|
| Rate for Payer: Galaxy Health WC |
$8,757.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,181.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,272.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$992.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,542.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,096.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,078.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,060.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7,212.10
|
| Rate for Payer: Multiplan Commercial |
$7,727.25
|
| Rate for Payer: Networks By Design Commercial |
$6,696.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,757.55
|
| Rate for Payer: Riverside University Health System MISP |
$4,121.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6,181.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$5,151.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1,593.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,093.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,000.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8,757.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,757.55
|
| Rate for Payer: Vantage Medical Group Senior |
$8,757.55
|
|
|
HC TRLUML BLLN ANGIO ADDL VEIN
|
Facility
|
IP
|
$10,303.00
|
|
|
Service Code
|
CPT 37249
|
| Hospital Charge Code |
909037249
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,060.60 |
| Max. Negotiated Rate |
$9,272.70 |
| Rate for Payer: Adventist Health Commercial |
$2,060.60
|
| Rate for Payer: Cash Price |
$4,636.35
|
| Rate for Payer: Central Health Plan Commercial |
$8,242.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7,212.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4,121.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4,121.20
|
| Rate for Payer: Galaxy Health WC |
$8,757.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6,181.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$9,272.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6,542.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6,078.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,060.60
|
| Rate for Payer: Multiplan Commercial |
$7,727.25
|
| Rate for Payer: Networks By Design Commercial |
$6,696.95
|
| Rate for Payer: Prime Health Services Commercial |
$8,757.55
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
|
IP
|
$24,047.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
909037246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,809.40 |
| Max. Negotiated Rate |
$21,642.30 |
| Rate for Payer: Adventist Health Commercial |
$4,809.40
|
| Rate for Payer: Cash Price |
$10,821.15
|
| Rate for Payer: Central Health Plan Commercial |
$19,237.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,832.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,618.80
|
| Rate for Payer: EPIC Health Plan Senior |
$9,618.80
|
| Rate for Payer: Galaxy Health WC |
$20,439.95
|
| Rate for Payer: Global Benefits Group Commercial |
$14,428.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,642.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,269.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,187.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,809.40
|
| Rate for Payer: Multiplan Commercial |
$18,035.25
|
| Rate for Payer: Networks By Design Commercial |
$15,630.55
|
| Rate for Payer: Prime Health Services Commercial |
$20,439.95
|
|
|
HC TRLUML BLLN ANGIO INIT ART
|
Facility
|
OP
|
$24,047.00
|
|
|
Service Code
|
CPT 37246
|
| Hospital Charge Code |
909037246
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,069.82 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,809.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,320.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,542.58
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$10,821.15
|
| Rate for Payer: Cash Price |
$10,821.15
|
| Rate for Payer: Cash Price |
$10,821.15
|
| Rate for Payer: Central Health Plan Commercial |
$19,237.60
|
| Rate for Payer: Cigna of CA HMO |
$15,390.08
|
| Rate for Payer: Cigna of CA PPO |
$17,794.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16,832.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,078.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8,052.33
|
| Rate for Payer: Galaxy Health WC |
$20,439.95
|
| Rate for Payer: Global Benefits Group Commercial |
$14,428.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$21,642.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,005.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,372.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15,269.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3,725.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,809.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$18,035.25
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$15,630.55
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Preferred Health Network WC |
$11,778.14
|
| Rate for Payer: Prime Health Services Commercial |
$20,439.95
|
| Rate for Payer: Prime Health Services Medicare |
$7,759.52
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Riverside University Health System MISP |
$8,052.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14,428.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,023.50
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,320.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC TRLUML BLLN ANGIO INIT VEIN
|
Facility
|
IP
|
$20,606.00
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
909037248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$4,121.20 |
| Max. Negotiated Rate |
$18,545.40 |
| Rate for Payer: Adventist Health Commercial |
$4,121.20
|
| Rate for Payer: Cash Price |
$9,272.70
|
| Rate for Payer: Central Health Plan Commercial |
$16,484.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,424.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8,242.40
|
| Rate for Payer: EPIC Health Plan Senior |
$8,242.40
|
| Rate for Payer: Galaxy Health WC |
$17,515.10
|
| Rate for Payer: Global Benefits Group Commercial |
$12,363.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,545.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,084.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,157.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,121.20
|
| Rate for Payer: Multiplan Commercial |
$15,454.50
|
| Rate for Payer: Networks By Design Commercial |
$13,393.90
|
| Rate for Payer: Prime Health Services Commercial |
$17,515.10
|
|
|
HC TRLUML BLLN ANGIO INIT VEIN
|
Facility
|
OP
|
$20,606.00
|
|
|
Service Code
|
CPT 37248
|
| Hospital Charge Code |
909037248
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,069.82 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$4,121.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,320.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,320.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,924.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,542.58
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$9,272.70
|
| Rate for Payer: Cash Price |
$9,272.70
|
| Rate for Payer: Cash Price |
$9,272.70
|
| Rate for Payer: Central Health Plan Commercial |
$16,484.80
|
| Rate for Payer: Cigna of CA HMO |
$13,187.84
|
| Rate for Payer: Cigna of CA PPO |
$15,248.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,052.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,320.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14,424.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,078.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8,052.33
|
| Rate for Payer: Galaxy Health WC |
$17,515.10
|
| Rate for Payer: Global Benefits Group Commercial |
$12,363.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$18,545.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,005.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2,325.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13,084.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2,568.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,248.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4,121.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9,809.20
|
| Rate for Payer: Multiplan Commercial |
$15,454.50
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$13,393.90
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,320.30
|
| Rate for Payer: Preferred Health Network WC |
$11,778.14
|
| Rate for Payer: Prime Health Services Commercial |
$17,515.10
|
| Rate for Payer: Prime Health Services Medicare |
$7,759.52
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Riverside University Health System MISP |
$8,052.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12,363.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,303.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,320.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,980.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,052.33
|
| Rate for Payer: Vantage Medical Group Senior |
$7,320.30
|
|
|
HC TRMNT ANGER-PROBLEM SOLVING
|
Facility
|
OP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804064
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$610.00 |
| 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 |
$610.00
|
| 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 TRMNT ANGER-PROBLEM SOLVING
|
Facility
|
IP
|
$374.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804064
|
|
Hospital Revenue Code
|
905
|
| 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 TRMNT ED HEALTH EDUCATION
|
Facility
|
IP
|
$385.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804147
|
|
Hospital Revenue Code
|
905
|
| 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 TRMNT ED HEALTH EDUCATION
|
Facility
|
OP
|
$385.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804147
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$610.00 |
| 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 |
$610.00
|
| 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 TRMNT ED MENTAL HEALTH EDUCATION
|
Facility
|
IP
|
$385.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804146
|
|
Hospital Revenue Code
|
905
|
| 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 TRMNT ED MENTAL HEALTH EDUCATION
|
Facility
|
OP
|
$385.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804146
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$610.00 |
| 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 |
$610.00
|
| 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 TRMNT ED STRESS MANAGEMENT
|
Facility
|
OP
|
$402.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804148
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$80.40 |
| Max. Negotiated Rate |
$674.93 |
| 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 |
$610.00
|
| 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 TRMNT ED STRESS MANAGEMENT
|
Facility
|
IP
|
$402.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
907804148
|
|
Hospital Revenue Code
|
905
|
| 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 TRMNT MENTAL HEALTH EDUCATION
|
Facility
|
IP
|
$385.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804063
|
|
Hospital Revenue Code
|
905
|
| 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 TRMNT MENTAL HEALTH EDUCATION
|
Facility
|
OP
|
$385.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804063
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$610.00 |
| 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 |
$610.00
|
| 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 TRMNT SPEECH/LANG/DYSPHAGIA GRP
|
Facility
|
IP
|
$450.00
|
|
|
Service Code
|
CPT 92508
|
| Hospital Charge Code |
905601501
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$90.00 |
| Max. Negotiated Rate |
$405.00 |
| Rate for Payer: Adventist Health Commercial |
$90.00
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Central Health Plan Commercial |
$360.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Senior |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$285.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$265.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$90.00
|
| Rate for Payer: Multiplan Commercial |
$337.50
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP
|
Facility
|
OP
|
$450.00
|
|
|
Service Code
|
CPT 92508
|
| Hospital Charge Code |
905601501
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$184.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$155.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$382.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$247.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$337.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Cash Price |
$202.50
|
| Rate for Payer: Central Health Plan Commercial |
$360.00
|
| Rate for Payer: Cigna of CA HMO |
$288.00
|
| Rate for Payer: Cigna of CA PPO |
$333.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$382.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$382.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$382.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$315.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$180.00
|
| Rate for Payer: EPIC Health Plan Senior |
$180.00
|
| Rate for Payer: Galaxy Health WC |
$382.50
|
| Rate for Payer: Global Benefits Group Commercial |
$270.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$405.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$285.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$265.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$184.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$315.00
|
| Rate for Payer: Multiplan Commercial |
$337.50
|
| Rate for Payer: Networks By Design Commercial |
$292.50
|
| Rate for Payer: Prime Health Services Commercial |
$382.50
|
| Rate for Payer: Riverside University Health System MISP |
$180.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$270.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$270.00
|
| 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 |
$382.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$382.50
|
| Rate for Payer: Vantage Medical Group Senior |
$382.50
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP MCAL
|
Facility
|
IP
|
$650.00
|
|
|
Service Code
|
CPT X4302
|
| Hospital Charge Code |
907000038
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$130.00 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Adventist Health Commercial |
$130.00
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Central Health Plan Commercial |
$520.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.00
|
| Rate for Payer: EPIC Health Plan Senior |
$260.00
|
| Rate for Payer: Galaxy Health WC |
$552.50
|
| Rate for Payer: Global Benefits Group Commercial |
$390.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$585.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$412.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$383.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$130.00
|
| Rate for Payer: Multiplan Commercial |
$487.50
|
| Rate for Payer: Networks By Design Commercial |
$422.50
|
| Rate for Payer: Prime Health Services Commercial |
$552.50
|
|
|
HC TRMNT SPEECH/LANG/DYSPHAGIA GRP MCAL
|
Facility
|
OP
|
$650.00
|
|
|
Service Code
|
CPT X4302
|
| Hospital Charge Code |
907000038
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$45.70 |
| Max. Negotiated Rate |
$585.00 |
| Rate for Payer: Adventist Health Commercial |
$266.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$394.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$552.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$357.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$487.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Cash Price |
$292.50
|
| Rate for Payer: Central Health Plan Commercial |
$520.00
|
| Rate for Payer: Cigna of CA HMO |
$416.00
|
| Rate for Payer: Cigna of CA PPO |
$481.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$552.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$552.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$552.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$455.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$260.00
|
| Rate for Payer: EPIC Health Plan Senior |
$260.00
|
| Rate for Payer: Galaxy Health WC |
$552.50
|
| Rate for Payer: Global Benefits Group Commercial |
$390.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$585.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$45.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$412.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$50.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$383.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$266.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$455.00
|
| Rate for Payer: Multiplan Commercial |
$487.50
|
| Rate for Payer: Networks By Design Commercial |
$422.50
|
| Rate for Payer: Prime Health Services Commercial |
$552.50
|
| Rate for Payer: Riverside University Health System MISP |
$260.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$390.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$390.00
|
| 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 |
$552.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$552.50
|
| Rate for Payer: Vantage Medical Group Senior |
$552.50
|
|
|
HC TRMNT SPEECH/LANG/VOICE INDIV MCAL
|
Facility
|
OP
|
$774.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000041
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$317.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$464.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$657.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$425.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$580.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$465.00
|
| Rate for Payer: Blue Shield of California Commercial |
$427.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Central Health Plan Commercial |
$619.20
|
| Rate for Payer: Cigna of CA HMO |
$495.36
|
| Rate for Payer: Cigna of CA PPO |
$572.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$657.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$657.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$657.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$541.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$309.60
|
| Rate for Payer: Galaxy Health WC |
$657.90
|
| Rate for Payer: Global Benefits Group Commercial |
$464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$491.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$56.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$541.80
|
| Rate for Payer: Multiplan Commercial |
$580.50
|
| Rate for Payer: Networks By Design Commercial |
$503.10
|
| Rate for Payer: Prime Health Services Commercial |
$657.90
|
| Rate for Payer: Riverside University Health System MISP |
$309.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$464.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$464.40
|
| 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 |
$657.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$657.90
|
| Rate for Payer: Vantage Medical Group Senior |
$657.90
|
|
|
HC TRMNT SPEECH/LANG/VOICE INDIV MCAL
|
Facility
|
IP
|
$774.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000041
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$154.80 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$154.80
|
| Rate for Payer: Cash Price |
$348.30
|
| Rate for Payer: Central Health Plan Commercial |
$619.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$541.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$309.60
|
| Rate for Payer: EPIC Health Plan Senior |
$309.60
|
| Rate for Payer: Galaxy Health WC |
$657.90
|
| Rate for Payer: Global Benefits Group Commercial |
$464.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$696.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$491.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$456.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$154.80
|
| Rate for Payer: Multiplan Commercial |
$580.50
|
| Rate for Payer: Networks By Design Commercial |
$503.10
|
| Rate for Payer: Prime Health Services Commercial |
$657.90
|
|
