|
HC IOC TOUCH-PREP INITIAL PG
|
Facility
|
IP
|
$944.00
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
903800221
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$188.80 |
| Max. Negotiated Rate |
$849.60 |
| Rate for Payer: Adventist Health Commercial |
$188.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Central Health Plan Commercial |
$755.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$660.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$377.60
|
| Rate for Payer: EPIC Health Plan Senior |
$377.60
|
| Rate for Payer: Galaxy Health WC |
$802.40
|
| Rate for Payer: Global Benefits Group Commercial |
$566.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$849.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$599.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$556.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.80
|
| Rate for Payer: Multiplan Commercial |
$708.00
|
| Rate for Payer: Networks By Design Commercial |
$613.60
|
| Rate for Payer: Prime Health Services Commercial |
$802.40
|
|
|
HC IOC TOUCH-PREP INITIAL PG
|
Facility
|
OP
|
$944.00
|
|
|
Service Code
|
CPT 88333
|
| Hospital Charge Code |
903800221
|
|
Hospital Revenue Code
|
311
|
| Min. Negotiated Rate |
$119.41 |
| Max. Negotiated Rate |
$1,709.80 |
| Rate for Payer: Adventist Health Commercial |
$188.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$1,036.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$221.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1,036.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$119.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$166.00
|
| Rate for Payer: Blue Shield of California Commercial |
$594.72
|
| Rate for Payer: Blue Shield of California EPN |
$374.77
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Cash Price |
$424.80
|
| Rate for Payer: Central Health Plan Commercial |
$755.20
|
| Rate for Payer: Cigna of CA HMO |
$604.16
|
| Rate for Payer: Cigna of CA PPO |
$698.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,139.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1,036.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$660.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,709.80
|
| Rate for Payer: EPIC Health Plan Senior |
$1,139.86
|
| Rate for Payer: Galaxy Health WC |
$802.40
|
| Rate for Payer: Global Benefits Group Commercial |
$566.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$849.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,699.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$136.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1,036.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$599.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$150.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,450.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1,388.56
|
| Rate for Payer: Multiplan Commercial |
$708.00
|
| Rate for Payer: Networks By Design Commercial |
$613.60
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1,036.24
|
| Rate for Payer: Prime Health Services Commercial |
$802.40
|
| Rate for Payer: Prime Health Services Medicare |
$1,098.41
|
| Rate for Payer: Riverside University Health System MISP |
$1,139.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$566.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$566.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$542.12
|
| Rate for Payer: United Healthcare All Other HMO |
$542.12
|
| Rate for Payer: United Healthcare HMO Rider |
$542.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$542.12
|
| Rate for Payer: Upland Medical Group Pediatric |
$1,036.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,554.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,139.86
|
| Rate for Payer: Vantage Medical Group Senior |
$1,036.24
|
|
|
HC IONIZED CALCIUM
|
Facility
|
OP
|
$40.00
|
|
| Hospital Charge Code |
900912257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$8.00 |
| Max. Negotiated Rate |
$36.00 |
| Rate for Payer: Adventist Health Commercial |
$8.00
|
| Rate for Payer: Adventist Health Commercial |
$53.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$160.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$225.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$198.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$128.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.27
|
| Rate for Payer: Blue Shield of California Commercial |
$166.95
|
| Rate for Payer: Blue Shield of California Commercial |
$25.20
|
| Rate for Payer: Blue Shield of California EPN |
$15.88
|
| Rate for Payer: Blue Shield of California EPN |
$105.20
|
| Rate for Payer: Cash Price |
$18.00
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: Central Health Plan Commercial |
$32.00
|
| Rate for Payer: Central Health Plan Commercial |
$212.00
|
| Rate for Payer: Cigna of CA HMO |
$169.60
|
| Rate for Payer: Cigna of CA HMO |
$25.60
|
| Rate for Payer: Cigna of CA PPO |
$196.10
|
| Rate for Payer: Cigna of CA PPO |
$29.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$225.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$225.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$225.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.00
|
| Rate for Payer: EPIC Health Plan Senior |
$16.00
|
| Rate for Payer: EPIC Health Plan Senior |
$106.00
|
| Rate for Payer: Galaxy Health WC |
$34.00
|
| Rate for Payer: Galaxy Health WC |
$225.25
|
| Rate for Payer: Global Benefits Group Commercial |
$159.00
|
| Rate for Payer: Global Benefits Group Commercial |
$24.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$185.50
|
| Rate for Payer: Multiplan Commercial |
$30.00
|
| Rate for Payer: Multiplan Commercial |
$198.75
|
| Rate for Payer: Networks By Design Commercial |
$172.25
|
| Rate for Payer: Networks By Design Commercial |
$26.00
|
| Rate for Payer: Prime Health Services Commercial |
$225.25
|
| Rate for Payer: Prime Health Services Commercial |
$34.00
|
| Rate for Payer: Riverside University Health System MISP |
$16.00
|
| Rate for Payer: Riverside University Health System MISP |
$106.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$159.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$159.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$132.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.00
|
| Rate for Payer: United Healthcare All Other HMO |
$132.50
|
| Rate for Payer: United Healthcare All Other HMO |
$20.00
|
| Rate for Payer: United Healthcare HMO Rider |
$132.50
|
| Rate for Payer: United Healthcare HMO Rider |
$20.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$132.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$225.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$225.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.00
|
| Rate for Payer: Vantage Medical Group Senior |
$34.00
|
| Rate for Payer: Vantage Medical Group Senior |
$225.25
|
|
|
HC IONIZED CALCIUM
|
Facility
|
IP
|
$265.00
|
|
| Hospital Charge Code |
900912257
|
|
Hospital Revenue Code
|
301
|
| Min. Negotiated Rate |
$53.00 |
| Max. Negotiated Rate |
$238.50 |
| Rate for Payer: Adventist Health Commercial |
$53.00
|
| Rate for Payer: Cash Price |
$119.25
|
| Rate for Payer: Central Health Plan Commercial |
$212.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$185.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$106.00
|
| Rate for Payer: EPIC Health Plan Senior |
$106.00
|
| Rate for Payer: Galaxy Health WC |
$225.25
|
| Rate for Payer: Global Benefits Group Commercial |
$159.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$238.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$168.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$156.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.00
|
| Rate for Payer: Multiplan Commercial |
$198.75
|
| Rate for Payer: Networks By Design Commercial |
$172.25
|
| Rate for Payer: Prime Health Services Commercial |
$225.25
|
|
|
HC IONTOHORESIS 15MIN OT
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
905104123
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$80.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.00
|
| 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 |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$137.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Riverside University Health System MISP |
$78.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| 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 |
$166.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC IONTOHORESIS 15MIN OT
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
905104123
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC IONTOPHORESIS 15 MIN MCAL
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
900400027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$80.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.00
|
| 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 |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$137.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Riverside University Health System MISP |
$78.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| 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 |
$166.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC IONTOPHORESIS 15 MIN MCAL
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
900400027
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC IONTOPHORESIS 15 MIN MCARE COMM
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
900407033
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$80.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.00
|
| 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 |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$137.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Riverside University Health System MISP |
$78.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| 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 |
$166.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC IONTOPHORESIS 15 MIN MCARE COMM
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
900407033
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC IONTOPHORESIS 15 MIN PT
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
905103123
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC IONTOPHORESIS 15 MIN PT
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
900417033
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$80.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.00
|
| 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 |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$137.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Riverside University Health System MISP |
$78.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| 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 |
$166.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC IONTOPHORESIS 15 MIN PT
|
Facility
|
OP
|
$196.00
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
905103123
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$15.79 |
| Max. Negotiated Rate |
$465.00 |
| Rate for Payer: Adventist Health Commercial |
$80.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$130.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$166.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$107.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$147.00
|
| 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 |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Cigna of CA HMO |
$125.44
|
| Rate for Payer: Cigna of CA PPO |
$145.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$166.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$166.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$166.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$80.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$137.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
| Rate for Payer: Riverside University Health System MISP |
$78.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$117.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$117.60
|
| 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 |
$166.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$166.60
|
| Rate for Payer: Vantage Medical Group Senior |
$166.60
|
|
|
HC IONTOPHORESIS 15 MIN PT
|
Facility
|
IP
|
$196.00
|
|
|
Service Code
|
CPT 97033
|
| Hospital Charge Code |
900417033
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$39.20 |
| Max. Negotiated Rate |
$176.40 |
| Rate for Payer: Adventist Health Commercial |
$39.20
|
| Rate for Payer: Cash Price |
$88.20
|
| Rate for Payer: Central Health Plan Commercial |
$156.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$137.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$78.40
|
| Rate for Payer: EPIC Health Plan Senior |
$78.40
|
| Rate for Payer: Galaxy Health WC |
$166.60
|
| Rate for Payer: Global Benefits Group Commercial |
$117.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$176.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$124.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$115.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$39.20
|
| Rate for Payer: Multiplan Commercial |
$147.00
|
| Rate for Payer: Networks By Design Commercial |
$127.40
|
| Rate for Payer: Prime Health Services Commercial |
$166.60
|
|
|
HC IOP COGNITIVE THERAPY
|
Facility
|
IP
|
$430.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804061
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Adventist Health Commercial |
$86.00
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Central Health Plan Commercial |
$344.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$301.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.00
|
| Rate for Payer: EPIC Health Plan Senior |
$172.00
|
| Rate for Payer: Galaxy Health WC |
$365.50
|
| Rate for Payer: Global Benefits Group Commercial |
$258.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$387.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$273.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$253.70
|
| Rate for Payer: Multiplan Commercial |
$322.50
|
| Rate for Payer: Networks By Design Commercial |
$279.50
|
| Rate for Payer: Prime Health Services Commercial |
$365.50
|
|
|
HC IOP COGNITIVE THERAPY
|
Facility
|
OP
|
$430.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804061
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$610.00 |
| Rate for Payer: Adventist Health Commercial |
$86.00
|
| 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 |
$208.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$250.13
|
| Rate for Payer: Blue Shield of California Commercial |
$272.62
|
| Rate for Payer: Blue Shield of California EPN |
$171.57
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Central Health Plan Commercial |
$344.00
|
| Rate for Payer: Cigna of CA HMO |
$275.20
|
| Rate for Payer: Cigna of CA PPO |
$318.20
|
| 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 |
$301.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$365.50
|
| Rate for Payer: Global Benefits Group Commercial |
$258.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$387.00
|
| 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 |
$273.05
|
| 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 |
$322.50
|
| Rate for Payer: Networks By Design Commercial |
$279.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$365.50
|
| 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 |
$258.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$258.00
|
| 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 IOP CONNECTION GROUP
|
Facility
|
IP
|
$391.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804376
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$78.20 |
| Max. Negotiated Rate |
$351.90 |
| Rate for Payer: Adventist Health Commercial |
$78.20
|
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Central Health Plan Commercial |
$312.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$273.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$156.40
|
| Rate for Payer: EPIC Health Plan Senior |
$156.40
|
| Rate for Payer: Galaxy Health WC |
$332.35
|
| Rate for Payer: Global Benefits Group Commercial |
$234.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$248.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$230.69
|
| Rate for Payer: Multiplan Commercial |
$293.25
|
| Rate for Payer: Networks By Design Commercial |
$254.15
|
| Rate for Payer: Prime Health Services Commercial |
$332.35
|
|
|
HC IOP CONNECTION GROUP
|
Facility
|
OP
|
$391.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804376
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$610.00 |
| Rate for Payer: Adventist Health Commercial |
$78.20
|
| 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 |
$189.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$227.44
|
| Rate for Payer: Blue Shield of California Commercial |
$247.89
|
| Rate for Payer: Blue Shield of California EPN |
$156.01
|
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Cash Price |
$175.95
|
| Rate for Payer: Central Health Plan Commercial |
$312.80
|
| Rate for Payer: Cigna of CA HMO |
$250.24
|
| Rate for Payer: Cigna of CA PPO |
$289.34
|
| 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 |
$273.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$332.35
|
| Rate for Payer: Global Benefits Group Commercial |
$234.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$351.90
|
| 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 |
$248.28
|
| 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 |
$293.25
|
| Rate for Payer: Networks By Design Commercial |
$254.15
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$332.35
|
| 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 |
$234.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$234.60
|
| 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 IOP COPING SKILLS
|
Facility
|
OP
|
$430.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804060
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$610.00 |
| Rate for Payer: Adventist Health Commercial |
$86.00
|
| 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 |
$208.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$250.13
|
| Rate for Payer: Blue Shield of California Commercial |
$272.62
|
| Rate for Payer: Blue Shield of California EPN |
$171.57
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Central Health Plan Commercial |
$344.00
|
| Rate for Payer: Cigna of CA HMO |
$275.20
|
| Rate for Payer: Cigna of CA PPO |
$318.20
|
| 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 |
$301.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$365.50
|
| Rate for Payer: Global Benefits Group Commercial |
$258.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$387.00
|
| 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 |
$273.05
|
| 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 |
$322.50
|
| Rate for Payer: Networks By Design Commercial |
$279.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$365.50
|
| 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 |
$258.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$258.00
|
| 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 IOP COPING SKILLS
|
Facility
|
IP
|
$430.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804060
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$86.00 |
| Max. Negotiated Rate |
$387.00 |
| Rate for Payer: Adventist Health Commercial |
$86.00
|
| Rate for Payer: Cash Price |
$193.50
|
| Rate for Payer: Central Health Plan Commercial |
$344.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$301.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$172.00
|
| Rate for Payer: EPIC Health Plan Senior |
$172.00
|
| Rate for Payer: Galaxy Health WC |
$365.50
|
| Rate for Payer: Global Benefits Group Commercial |
$258.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$387.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$273.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$253.70
|
| Rate for Payer: Multiplan Commercial |
$322.50
|
| Rate for Payer: Networks By Design Commercial |
$279.50
|
| Rate for Payer: Prime Health Services Commercial |
$365.50
|
|
|
HC IOP ED COGNITIVE THERAPY
|
Facility
|
IP
|
$443.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804141
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$88.60 |
| Max. Negotiated Rate |
$398.70 |
| Rate for Payer: Adventist Health Commercial |
$88.60
|
| Rate for Payer: Cash Price |
$199.35
|
| Rate for Payer: Central Health Plan Commercial |
$354.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$310.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.20
|
| Rate for Payer: EPIC Health Plan Senior |
$177.20
|
| Rate for Payer: Galaxy Health WC |
$376.55
|
| Rate for Payer: Global Benefits Group Commercial |
$265.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$281.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$261.37
|
| Rate for Payer: Multiplan Commercial |
$332.25
|
| Rate for Payer: Networks By Design Commercial |
$287.95
|
| Rate for Payer: Prime Health Services Commercial |
$376.55
|
|
|
HC IOP ED COGNITIVE THERAPY
|
Facility
|
OP
|
$443.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804141
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$610.00 |
| Rate for Payer: Adventist Health Commercial |
$88.60
|
| 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 |
$214.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$257.69
|
| Rate for Payer: Blue Shield of California Commercial |
$280.86
|
| Rate for Payer: Blue Shield of California EPN |
$176.76
|
| Rate for Payer: Cash Price |
$199.35
|
| Rate for Payer: Cash Price |
$199.35
|
| Rate for Payer: Cash Price |
$199.35
|
| Rate for Payer: Central Health Plan Commercial |
$354.40
|
| Rate for Payer: Cigna of CA HMO |
$283.52
|
| Rate for Payer: Cigna of CA PPO |
$327.82
|
| 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 |
$310.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$376.55
|
| Rate for Payer: Global Benefits Group Commercial |
$265.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.70
|
| 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 |
$281.31
|
| 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 |
$332.25
|
| Rate for Payer: Networks By Design Commercial |
$287.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$376.55
|
| 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 |
$265.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$265.80
|
| 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 IOP ED COPING SKILLS
|
Facility
|
IP
|
$443.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804140
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$88.60 |
| Max. Negotiated Rate |
$398.70 |
| Rate for Payer: Adventist Health Commercial |
$88.60
|
| Rate for Payer: Cash Price |
$199.35
|
| Rate for Payer: Central Health Plan Commercial |
$354.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$310.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$177.20
|
| Rate for Payer: EPIC Health Plan Senior |
$177.20
|
| Rate for Payer: Galaxy Health WC |
$376.55
|
| Rate for Payer: Global Benefits Group Commercial |
$265.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$281.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$261.37
|
| Rate for Payer: Multiplan Commercial |
$332.25
|
| Rate for Payer: Networks By Design Commercial |
$287.95
|
| Rate for Payer: Prime Health Services Commercial |
$376.55
|
|
|
HC IOP ED COPING SKILLS
|
Facility
|
OP
|
$443.00
|
|
|
Service Code
|
CPT 90853
|
| Hospital Charge Code |
907804140
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$41.21 |
| Max. Negotiated Rate |
$610.00 |
| Rate for Payer: Adventist Health Commercial |
$88.60
|
| 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 |
$214.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$257.69
|
| Rate for Payer: Blue Shield of California Commercial |
$280.86
|
| Rate for Payer: Blue Shield of California EPN |
$176.76
|
| Rate for Payer: Cash Price |
$199.35
|
| Rate for Payer: Cash Price |
$199.35
|
| Rate for Payer: Cash Price |
$199.35
|
| Rate for Payer: Central Health Plan Commercial |
$354.40
|
| Rate for Payer: Cigna of CA HMO |
$283.52
|
| Rate for Payer: Cigna of CA PPO |
$327.82
|
| 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 |
$310.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$215.59
|
| Rate for Payer: EPIC Health Plan Senior |
$143.73
|
| Rate for Payer: Galaxy Health WC |
$376.55
|
| Rate for Payer: Global Benefits Group Commercial |
$265.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$398.70
|
| 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 |
$281.31
|
| 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 |
$332.25
|
| Rate for Payer: Networks By Design Commercial |
$287.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$130.66
|
| Rate for Payer: Prime Health Services Commercial |
$376.55
|
| 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 |
$265.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$265.80
|
| 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 IOP ED FAMILY THERAPY W PATIENT
|
Facility
|
OP
|
$553.00
|
|
|
Service Code
|
CPT 90847
|
| Hospital Charge Code |
907804156
|
|
Hospital Revenue Code
|
905
|
| Min. Negotiated Rate |
$87.72 |
| Max. Negotiated Rate |
$797.64 |
| Rate for Payer: Adventist Health Commercial |
$110.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$228.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$797.64
|
| 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 |
$267.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$321.68
|
| Rate for Payer: Blue Shield of California Commercial |
$350.60
|
| Rate for Payer: Blue Shield of California EPN |
$220.65
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Cash Price |
$248.85
|
| Rate for Payer: Central Health Plan Commercial |
$442.40
|
| Rate for Payer: Cigna of CA HMO |
$353.92
|
| Rate for Payer: Cigna of CA PPO |
$409.22
|
| 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 |
$387.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.68
|
| Rate for Payer: EPIC Health Plan Senior |
$251.12
|
| Rate for Payer: Galaxy Health WC |
$470.05
|
| Rate for Payer: Global Benefits Group Commercial |
$331.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$497.70
|
| 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 |
$87.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$228.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$351.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$96.90
|
| 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 |
$414.75
|
| Rate for Payer: Networks By Design Commercial |
$359.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$228.29
|
| Rate for Payer: Prime Health Services Commercial |
$470.05
|
| 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 |
$331.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$331.80
|
| 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
|
|
