|
HC EVAL CENT AUD FUNC ADD 15 MIN
|
Facility
|
OP
|
$76.00
|
|
|
Service Code
|
CPT 92621
|
| Hospital Charge Code |
905601906
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$17.39 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$31.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$46.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$64.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$57.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$80.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$41.80
|
| Rate for Payer: Cash Price |
$41.80
|
| Rate for Payer: Cash Price |
$41.80
|
| Rate for Payer: Cash Price |
$41.80
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: Cigna of CA HMO |
$48.64
|
| Rate for Payer: Cigna of CA PPO |
$56.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$64.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$64.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$64.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.40
|
| Rate for Payer: EPIC Health Plan Senior |
$30.40
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17.39
|
| Rate for Payer: InnovAge PACE Commercial |
$38.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$53.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$53.20
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
| Rate for Payer: Riverside University Health System MISP |
$30.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$45.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$45.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$64.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$64.60
|
| Rate for Payer: Vantage Medical Group Senior |
$64.60
|
|
|
HC EVAL CENT AUD FUNC ADD 15 MIN
|
Facility
|
IP
|
$76.00
|
|
|
Service Code
|
CPT 92621
|
| Hospital Charge Code |
905601906
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$15.20 |
| Max. Negotiated Rate |
$68.40 |
| Rate for Payer: Adventist Health Commercial |
$15.20
|
| Rate for Payer: Cash Price |
$41.80
|
| Rate for Payer: Central Health Plan Commercial |
$60.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.40
|
| Rate for Payer: EPIC Health Plan Senior |
$30.40
|
| Rate for Payer: Galaxy Health WC |
$64.60
|
| Rate for Payer: Global Benefits Group Commercial |
$45.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$68.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$50.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$28.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.20
|
| Rate for Payer: Multiplan Commercial |
$57.00
|
| Rate for Payer: Networks By Design Commercial |
$49.40
|
| Rate for Payer: Prime Health Services Commercial |
$64.60
|
|
|
HC EVAL FOR PRESCRIPT VOICE PROST
|
Facility
|
OP
|
$722.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
905601758
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$165.07 |
| Max. Negotiated Rate |
$649.80 |
| Rate for Payer: Adventist Health Commercial |
$296.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$438.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$613.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$397.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$541.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$397.10
|
| Rate for Payer: Cash Price |
$397.10
|
| Rate for Payer: Cash Price |
$397.10
|
| Rate for Payer: Cash Price |
$397.10
|
| Rate for Payer: Central Health Plan Commercial |
$577.60
|
| Rate for Payer: Cigna of CA HMO |
$462.08
|
| Rate for Payer: Cigna of CA PPO |
$534.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$613.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$613.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$613.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.80
|
| Rate for Payer: EPIC Health Plan Senior |
$288.80
|
| Rate for Payer: Galaxy Health WC |
$613.70
|
| Rate for Payer: Global Benefits Group Commercial |
$433.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$649.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$165.07
|
| Rate for Payer: InnovAge PACE Commercial |
$361.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$481.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$446.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$505.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$505.40
|
| Rate for Payer: Multiplan Commercial |
$541.50
|
| Rate for Payer: Networks By Design Commercial |
$469.30
|
| Rate for Payer: Prime Health Services Commercial |
$613.70
|
| Rate for Payer: Riverside University Health System MISP |
$288.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$433.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$433.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$613.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$613.70
|
| Rate for Payer: Vantage Medical Group Senior |
$613.70
|
|
|
HC EVAL FOR PRESCRIPT VOICE PROST
|
Facility
|
IP
|
$722.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
905601758
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$144.40 |
| Max. Negotiated Rate |
$649.80 |
| Rate for Payer: Adventist Health Commercial |
$144.40
|
| Rate for Payer: Cash Price |
$397.10
|
| Rate for Payer: Central Health Plan Commercial |
$577.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.80
|
| Rate for Payer: EPIC Health Plan Senior |
$288.80
|
| Rate for Payer: Galaxy Health WC |
$613.70
|
| Rate for Payer: Global Benefits Group Commercial |
$433.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$649.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$481.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$446.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.40
|
| Rate for Payer: Multiplan Commercial |
$541.50
|
| Rate for Payer: Networks By Design Commercial |
$469.30
|
| Rate for Payer: Prime Health Services Commercial |
$613.70
|
|
|
HC EVAL OF FNA,EA ADDLL SITE PG
|
Facility
|
OP
|
$14.00
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
903800217
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$41.31 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.65
|
| Rate for Payer: Blue Shield of California Commercial |
$8.50
|
| Rate for Payer: Blue Shield of California EPN |
$5.56
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Central Health Plan Commercial |
$11.20
|
| Rate for Payer: Cigna of CA HMO |
$8.96
|
| Rate for Payer: Cigna of CA PPO |
$10.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5.60
|
| Rate for Payer: Galaxy Health WC |
$11.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$37.39
|
| Rate for Payer: InnovAge PACE Commercial |
$7.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.80
|
| Rate for Payer: Multiplan Commercial |
$10.50
|
| Rate for Payer: Networks By Design Commercial |
$9.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.90
|
| Rate for Payer: Riverside University Health System MISP |
$5.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.89
|
| Rate for Payer: United Healthcare All Other HMO |
$5.89
|
| Rate for Payer: United Healthcare HMO Rider |
$5.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.90
|
| Rate for Payer: Vantage Medical Group Senior |
$11.90
|
|
|
HC EVAL OF FNA,EA ADDLL SITE PG
|
Facility
|
IP
|
$14.00
|
|
|
Service Code
|
CPT 88177
|
| Hospital Charge Code |
903800217
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$12.60 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Cash Price |
$7.70
|
| Rate for Payer: Central Health Plan Commercial |
$11.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.60
|
| Rate for Payer: EPIC Health Plan Senior |
$5.60
|
| Rate for Payer: Galaxy Health WC |
$11.90
|
| Rate for Payer: Global Benefits Group Commercial |
$8.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Multiplan Commercial |
$10.50
|
| Rate for Payer: Networks By Design Commercial |
$9.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.90
|
|
|
HC EVAL OF FNA INITIAL PG
|
Facility
|
OP
|
$314.00
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
903800216
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$15.36 |
| Max. Negotiated Rate |
$357.08 |
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$217.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$190.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.73
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$75.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.36
|
| Rate for Payer: Blue Shield of California Commercial |
$190.60
|
| Rate for Payer: Blue Shield of California EPN |
$124.66
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Central Health Plan Commercial |
$251.20
|
| Rate for Payer: Cigna of CA HMO |
$200.96
|
| Rate for Payer: Cigna of CA PPO |
$232.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$326.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$239.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$217.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$293.94
|
| Rate for Payer: EPIC Health Plan Senior |
$217.73
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$282.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$357.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$48.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$217.73
|
| Rate for Payer: InnovAge PACE Commercial |
$326.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$209.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$217.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$291.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$291.76
|
| Rate for Payer: Multiplan Commercial |
$235.50
|
| Rate for Payer: Networks By Design Commercial |
$204.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$217.73
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
| Rate for Payer: Prime Health Services Medicare |
$230.79
|
| Rate for Payer: Riverside University Health System MISP |
$239.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$188.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$188.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.38
|
| Rate for Payer: United Healthcare All Other HMO |
$123.38
|
| Rate for Payer: United Healthcare HMO Rider |
$123.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$217.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$326.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$239.50
|
| Rate for Payer: Vantage Medical Group Senior |
$217.73
|
|
|
HC EVAL OF FNA INITIAL PG
|
Facility
|
IP
|
$314.00
|
|
|
Service Code
|
CPT 88172
|
| Hospital Charge Code |
903800216
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$62.80 |
| Max. Negotiated Rate |
$282.60 |
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Central Health Plan Commercial |
$251.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$125.60
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$282.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$209.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.80
|
| Rate for Payer: Multiplan Commercial |
$235.50
|
| Rate for Payer: Networks By Design Commercial |
$204.10
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
|
|
HC EVAL OF SWALLOW W/RADIOLOGY
|
Facility
|
IP
|
$1,193.00
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
905601754
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$238.60 |
| Max. Negotiated Rate |
$1,073.70 |
| Rate for Payer: Adventist Health Commercial |
$238.60
|
| Rate for Payer: Cash Price |
$656.15
|
| Rate for Payer: Central Health Plan Commercial |
$954.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$477.20
|
| Rate for Payer: EPIC Health Plan Senior |
$477.20
|
| Rate for Payer: Galaxy Health WC |
$1,014.05
|
| Rate for Payer: Global Benefits Group Commercial |
$715.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,073.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$795.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$454.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$738.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$238.60
|
| Rate for Payer: Multiplan Commercial |
$894.75
|
| Rate for Payer: Networks By Design Commercial |
$775.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,014.05
|
|
|
HC EVAL OF SWALLOW W/RADIOLOGY
|
Facility
|
OP
|
$1,193.00
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
905601754
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$68.71 |
| Max. Negotiated Rate |
$1,073.70 |
| Rate for Payer: Adventist Health Commercial |
$489.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$724.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,014.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$656.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$894.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$656.15
|
| Rate for Payer: Cash Price |
$656.15
|
| Rate for Payer: Cash Price |
$656.15
|
| Rate for Payer: Cash Price |
$656.15
|
| Rate for Payer: Central Health Plan Commercial |
$954.40
|
| Rate for Payer: Cigna of CA HMO |
$763.52
|
| Rate for Payer: Cigna of CA PPO |
$882.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,014.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,014.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,014.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$477.20
|
| Rate for Payer: EPIC Health Plan Senior |
$477.20
|
| Rate for Payer: Galaxy Health WC |
$1,014.05
|
| Rate for Payer: Global Benefits Group Commercial |
$715.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,073.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$68.71
|
| Rate for Payer: InnovAge PACE Commercial |
$596.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$795.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$75.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$738.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$489.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$835.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$835.10
|
| Rate for Payer: Multiplan Commercial |
$894.75
|
| Rate for Payer: Networks By Design Commercial |
$775.45
|
| Rate for Payer: Prime Health Services Commercial |
$1,014.05
|
| Rate for Payer: Riverside University Health System MISP |
$477.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$715.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$715.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,014.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,014.05
|
| Rate for Payer: Vantage Medical Group Senior |
$1,014.05
|
|
|
HC EVAL REVAL FOR PRESCRIPT SPCH DEVICE
|
Facility
|
OP
|
$549.00
|
|
|
Service Code
|
CPT 92605
|
| Hospital Charge Code |
905601755
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$59.79 |
| Max. Negotiated Rate |
$494.10 |
| Rate for Payer: Adventist Health Commercial |
$225.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$333.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$466.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$301.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$411.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Central Health Plan Commercial |
$439.20
|
| Rate for Payer: Cigna of CA HMO |
$351.36
|
| Rate for Payer: Cigna of CA PPO |
$406.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$466.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$466.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$466.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$219.60
|
| Rate for Payer: EPIC Health Plan Senior |
$219.60
|
| Rate for Payer: Galaxy Health WC |
$466.65
|
| Rate for Payer: Global Benefits Group Commercial |
$329.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$494.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.79
|
| Rate for Payer: InnovAge PACE Commercial |
$274.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$366.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$339.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.30
|
| Rate for Payer: Multiplan Commercial |
$411.75
|
| Rate for Payer: Networks By Design Commercial |
$356.85
|
| Rate for Payer: Prime Health Services Commercial |
$466.65
|
| Rate for Payer: Riverside University Health System MISP |
$219.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$329.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$329.40
|
| 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 |
$466.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$466.65
|
| Rate for Payer: Vantage Medical Group Senior |
$466.65
|
|
|
HC EVAL REVAL FOR PRESCRIPT SPCH DEVICE
|
Facility
|
IP
|
$549.00
|
|
|
Service Code
|
CPT 92605
|
| Hospital Charge Code |
905601755
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$109.80 |
| Max. Negotiated Rate |
$494.10 |
| Rate for Payer: Adventist Health Commercial |
$109.80
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Central Health Plan Commercial |
$439.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$219.60
|
| Rate for Payer: EPIC Health Plan Senior |
$219.60
|
| Rate for Payer: Galaxy Health WC |
$466.65
|
| Rate for Payer: Global Benefits Group Commercial |
$329.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$494.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$366.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$339.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.80
|
| Rate for Payer: Multiplan Commercial |
$411.75
|
| Rate for Payer: Networks By Design Commercial |
$356.85
|
| Rate for Payer: Prime Health Services Commercial |
$466.65
|
|
|
HC EVAL/REVAL FOR PRESCRIPT SPCH DEVICE MCAL
|
Facility
|
IP
|
$549.00
|
|
|
Service Code
|
CPT 92605
|
| Hospital Charge Code |
907000025
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$109.80 |
| Max. Negotiated Rate |
$494.10 |
| Rate for Payer: Adventist Health Commercial |
$109.80
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Central Health Plan Commercial |
$439.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$219.60
|
| Rate for Payer: EPIC Health Plan Senior |
$219.60
|
| Rate for Payer: Galaxy Health WC |
$466.65
|
| Rate for Payer: Global Benefits Group Commercial |
$329.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$494.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$366.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$209.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$339.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$109.80
|
| Rate for Payer: Multiplan Commercial |
$411.75
|
| Rate for Payer: Networks By Design Commercial |
$356.85
|
| Rate for Payer: Prime Health Services Commercial |
$466.65
|
|
|
HC EVAL/REVAL FOR PRESCRIPT SPCH DEVICE MCAL
|
Facility
|
OP
|
$549.00
|
|
|
Service Code
|
CPT 92605
|
| Hospital Charge Code |
907000025
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$59.79 |
| Max. Negotiated Rate |
$494.10 |
| Rate for Payer: Adventist Health Commercial |
$225.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$333.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$466.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$301.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$411.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Cash Price |
$301.95
|
| Rate for Payer: Central Health Plan Commercial |
$439.20
|
| Rate for Payer: Cigna of CA HMO |
$351.36
|
| Rate for Payer: Cigna of CA PPO |
$406.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$466.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$466.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$466.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$219.60
|
| Rate for Payer: EPIC Health Plan Senior |
$219.60
|
| Rate for Payer: Galaxy Health WC |
$466.65
|
| Rate for Payer: Global Benefits Group Commercial |
$329.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$494.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$59.79
|
| Rate for Payer: InnovAge PACE Commercial |
$274.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$366.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$339.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$225.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$384.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$384.30
|
| Rate for Payer: Multiplan Commercial |
$411.75
|
| Rate for Payer: Networks By Design Commercial |
$356.85
|
| Rate for Payer: Prime Health Services Commercial |
$466.65
|
| Rate for Payer: Riverside University Health System MISP |
$219.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$329.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$329.40
|
| 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 |
$466.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$466.65
|
| Rate for Payer: Vantage Medical Group Senior |
$466.65
|
|
|
HC EVAL RX SPEECH DVC 1ST HR MCAL
|
Facility
|
OP
|
$722.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
907000017
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$165.07 |
| Max. Negotiated Rate |
$649.80 |
| Rate for Payer: Adventist Health Commercial |
$296.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$438.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$613.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$397.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$541.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$397.10
|
| Rate for Payer: Cash Price |
$397.10
|
| Rate for Payer: Cash Price |
$397.10
|
| Rate for Payer: Cash Price |
$397.10
|
| Rate for Payer: Central Health Plan Commercial |
$577.60
|
| Rate for Payer: Cigna of CA HMO |
$462.08
|
| Rate for Payer: Cigna of CA PPO |
$534.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$613.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$613.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$613.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.80
|
| Rate for Payer: EPIC Health Plan Senior |
$288.80
|
| Rate for Payer: Galaxy Health WC |
$613.70
|
| Rate for Payer: Global Benefits Group Commercial |
$433.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$649.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$165.07
|
| Rate for Payer: InnovAge PACE Commercial |
$361.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$481.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$446.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$296.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$505.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$505.40
|
| Rate for Payer: Multiplan Commercial |
$541.50
|
| Rate for Payer: Networks By Design Commercial |
$469.30
|
| Rate for Payer: Prime Health Services Commercial |
$613.70
|
| Rate for Payer: Riverside University Health System MISP |
$288.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$433.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$433.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$613.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$613.70
|
| Rate for Payer: Vantage Medical Group Senior |
$613.70
|
|
|
HC EVAL RX SPEECH DVC 1ST HR MCAL
|
Facility
|
IP
|
$722.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
907000017
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$144.40 |
| Max. Negotiated Rate |
$649.80 |
| Rate for Payer: Adventist Health Commercial |
$144.40
|
| Rate for Payer: Cash Price |
$397.10
|
| Rate for Payer: Central Health Plan Commercial |
$577.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$288.80
|
| Rate for Payer: EPIC Health Plan Senior |
$288.80
|
| Rate for Payer: Galaxy Health WC |
$613.70
|
| Rate for Payer: Global Benefits Group Commercial |
$433.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$649.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$481.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$275.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$446.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$144.40
|
| Rate for Payer: Multiplan Commercial |
$541.50
|
| Rate for Payer: Networks By Design Commercial |
$469.30
|
| Rate for Payer: Prime Health Services Commercial |
$613.70
|
|
|
HC EVAL RX SPEECH DVC EA ADDL 30MIN MCAL
|
Facility
|
IP
|
$314.00
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
907000019
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$62.80 |
| Max. Negotiated Rate |
$282.60 |
| Rate for Payer: Adventist Health Commercial |
$62.80
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Central Health Plan Commercial |
$251.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$125.60
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$282.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$209.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$119.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$62.80
|
| Rate for Payer: Multiplan Commercial |
$235.50
|
| Rate for Payer: Networks By Design Commercial |
$204.10
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
|
|
HC EVAL RX SPEECH DVC EA ADDL 30MIN MCAL
|
Facility
|
OP
|
$314.00
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
907000019
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$32.34 |
| Max. Negotiated Rate |
$447.00 |
| Rate for Payer: Adventist Health Commercial |
$128.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$190.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$266.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$172.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$235.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Cash Price |
$172.70
|
| Rate for Payer: Central Health Plan Commercial |
$251.20
|
| Rate for Payer: Cigna of CA HMO |
$200.96
|
| Rate for Payer: Cigna of CA PPO |
$232.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$266.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$266.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$266.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$125.60
|
| Rate for Payer: Galaxy Health WC |
$266.90
|
| Rate for Payer: Global Benefits Group Commercial |
$188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$282.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$32.34
|
| Rate for Payer: InnovAge PACE Commercial |
$157.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$209.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$194.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$128.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$219.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$219.80
|
| Rate for Payer: Multiplan Commercial |
$235.50
|
| Rate for Payer: Networks By Design Commercial |
$204.10
|
| Rate for Payer: Prime Health Services Commercial |
$266.90
|
| Rate for Payer: Riverside University Health System MISP |
$125.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$188.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$188.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$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 |
$266.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$266.90
|
| Rate for Payer: Vantage Medical Group Senior |
$266.90
|
|
|
HC EVAL SPEECH FLUENCY
|
Facility
|
IP
|
$963.00
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
900100000
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$192.60 |
| Max. Negotiated Rate |
$866.70 |
| Rate for Payer: Adventist Health Commercial |
$192.60
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Central Health Plan Commercial |
$770.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$385.20
|
| Rate for Payer: EPIC Health Plan Senior |
$385.20
|
| Rate for Payer: Galaxy Health WC |
$818.55
|
| Rate for Payer: Global Benefits Group Commercial |
$577.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$866.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$642.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$366.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$596.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$192.60
|
| Rate for Payer: Multiplan Commercial |
$722.25
|
| Rate for Payer: Networks By Design Commercial |
$625.95
|
| Rate for Payer: Prime Health Services Commercial |
$818.55
|
|
|
HC EVAL SPEECH FLUENCY
|
Facility
|
OP
|
$963.00
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
900100000
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$128.97 |
| Max. Negotiated Rate |
$866.70 |
| Rate for Payer: Adventist Health Commercial |
$394.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$584.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$818.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$529.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$722.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Cash Price |
$529.65
|
| Rate for Payer: Central Health Plan Commercial |
$770.40
|
| Rate for Payer: Cigna of CA HMO |
$616.32
|
| Rate for Payer: Cigna of CA PPO |
$712.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$818.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$818.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$818.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$385.20
|
| Rate for Payer: EPIC Health Plan Senior |
$385.20
|
| Rate for Payer: Galaxy Health WC |
$818.55
|
| Rate for Payer: Global Benefits Group Commercial |
$577.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$866.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$128.97
|
| Rate for Payer: InnovAge PACE Commercial |
$481.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$642.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$596.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$394.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$674.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$674.10
|
| Rate for Payer: Multiplan Commercial |
$722.25
|
| Rate for Payer: Networks By Design Commercial |
$625.95
|
| Rate for Payer: Prime Health Services Commercial |
$818.55
|
| Rate for Payer: Riverside University Health System MISP |
$385.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$577.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$577.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$818.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$818.55
|
| Rate for Payer: Vantage Medical Group Senior |
$818.55
|
|
|
HC EVAL SPEECH/LANGUAGE/VOICE PRELIM MCAL
|
Facility
|
OP
|
$993.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000021
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$51.12 |
| Max. Negotiated Rate |
$893.70 |
| Rate for Payer: Adventist Health Commercial |
$407.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$603.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$844.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$546.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$744.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$546.15
|
| Rate for Payer: Cash Price |
$546.15
|
| Rate for Payer: Cash Price |
$546.15
|
| Rate for Payer: Cash Price |
$546.15
|
| Rate for Payer: Central Health Plan Commercial |
$794.40
|
| Rate for Payer: Cigna of CA HMO |
$635.52
|
| Rate for Payer: Cigna of CA PPO |
$734.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$844.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$844.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$844.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.20
|
| Rate for Payer: EPIC Health Plan Senior |
$397.20
|
| Rate for Payer: Galaxy Health WC |
$844.05
|
| Rate for Payer: Global Benefits Group Commercial |
$595.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$893.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$51.12
|
| Rate for Payer: InnovAge PACE Commercial |
$496.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$662.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$614.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$407.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$695.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$695.10
|
| Rate for Payer: Multiplan Commercial |
$744.75
|
| Rate for Payer: Networks By Design Commercial |
$645.45
|
| Rate for Payer: Prime Health Services Commercial |
$844.05
|
| Rate for Payer: Riverside University Health System MISP |
$397.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$595.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$595.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$417.00
|
| Rate for Payer: United Healthcare All Other HMO |
$295.00
|
| Rate for Payer: United Healthcare HMO Rider |
$224.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$206.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$844.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$844.05
|
| Rate for Payer: Vantage Medical Group Senior |
$844.05
|
|
|
HC EVAL SPEECH/LANGUAGE/VOICE PRELIM MCAL
|
Facility
|
IP
|
$993.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000021
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$198.60 |
| Max. Negotiated Rate |
$893.70 |
| Rate for Payer: Adventist Health Commercial |
$198.60
|
| Rate for Payer: Cash Price |
$546.15
|
| Rate for Payer: Central Health Plan Commercial |
$794.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$397.20
|
| Rate for Payer: EPIC Health Plan Senior |
$397.20
|
| Rate for Payer: Galaxy Health WC |
$844.05
|
| Rate for Payer: Global Benefits Group Commercial |
$595.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$893.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$662.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$378.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$614.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$198.60
|
| Rate for Payer: Multiplan Commercial |
$744.75
|
| Rate for Payer: Networks By Design Commercial |
$645.45
|
| Rate for Payer: Prime Health Services Commercial |
$844.05
|
|
|
HC EVAL SPEECH SOUND PRODUCTION
|
Facility
|
IP
|
$774.00
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
900100001
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$154.80 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$154.80
|
| Rate for Payer: Cash Price |
$425.70
|
| Rate for Payer: Central Health Plan Commercial |
$619.20
|
| 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 Permanente of CA Commercial/Self Funded |
$516.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.11
|
| 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
|
|
|
HC EVAL SPEECH SOUND PRODUCTION
|
Facility
|
OP
|
$774.00
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
900100001
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$92.60 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$317.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$470.05
|
| 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 |
$447.00
|
| Rate for Payer: Blue Shield of California Commercial |
$412.00
|
| Rate for Payer: Blue Shield of California EPN |
$268.00
|
| Rate for Payer: Cash Price |
$425.70
|
| Rate for Payer: Cash Price |
$425.70
|
| Rate for Payer: Cash Price |
$425.70
|
| Rate for Payer: Cash Price |
$425.70
|
| 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: 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 |
$92.60
|
| Rate for Payer: InnovAge PACE Commercial |
$387.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$516.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$317.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$541.80
|
| Rate for Payer: Molina Healthcare of CA 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 EVAL SPEECH SOUND PROD W LANG COMP EXPRES
|
Facility
|
IP
|
$774.00
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
900100002
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$154.80 |
| Max. Negotiated Rate |
$696.60 |
| Rate for Payer: Adventist Health Commercial |
$154.80
|
| Rate for Payer: Cash Price |
$425.70
|
| Rate for Payer: Central Health Plan Commercial |
$619.20
|
| 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 Permanente of CA Commercial/Self Funded |
$516.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$294.89
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$479.11
|
| 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
|
|
