|
HC EVAL/REVAL FOR PRESCRIPT SPCH DEVICE MCAL
|
Facility
|
OP
|
$610.00
|
|
|
Service Code
|
CPT 92605
|
| Hospital Charge Code |
907000025
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$66.04 |
| Max. Negotiated Rate |
$549.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$370.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$518.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$335.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$335.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$366.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Central Health Plan Commercial |
$488.00
|
| Rate for Payer: Cigna of CA HMO |
$390.40
|
| Rate for Payer: Cigna of CA PPO |
$451.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$518.50
|
| Rate for Payer: Dignity Health Media |
$518.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$518.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$244.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$244.00
|
| Rate for Payer: Galaxy Health WC |
$518.50
|
| Rate for Payer: Global Benefits Group Commercial |
$366.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$549.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$457.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$213.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$406.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$66.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$250.10
|
| Rate for Payer: Multiplan Commercial |
$457.50
|
| Rate for Payer: Networks By Design Commercial |
$396.50
|
| Rate for Payer: Prime Health Services Commercial |
$518.50
|
| Rate for Payer: Riverside University Health System MISP |
$244.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$366.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$366.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$518.50
|
| Rate for Payer: Vantage Medical Group Senior |
$518.50
|
|
|
HC EVAL/REVAL FOR PRESCRIPT SPCH DEVICE MCAL
|
Facility
|
IP
|
$610.00
|
|
|
Service Code
|
CPT 92605
|
| Hospital Charge Code |
907000025
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$122.00 |
| Max. Negotiated Rate |
$549.00 |
| Rate for Payer: Cash Price |
$274.50
|
| Rate for Payer: Central Health Plan Commercial |
$488.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$244.00
|
| Rate for Payer: Galaxy Health WC |
$518.50
|
| Rate for Payer: Global Benefits Group Commercial |
$366.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$549.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$406.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$232.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.00
|
| Rate for Payer: Multiplan Commercial |
$457.50
|
| Rate for Payer: Networks By Design Commercial |
$396.50
|
| Rate for Payer: Prime Health Services Commercial |
$518.50
|
|
|
HC EVAL RX SPEECH DVC 1ST HR MCAL
|
Facility
|
OP
|
$802.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
907000017
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$182.34 |
| Max. Negotiated Rate |
$1,040.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,040.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$681.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$441.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$441.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$481.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$360.90
|
| Rate for Payer: Cash Price |
$360.90
|
| Rate for Payer: Cash Price |
$360.90
|
| Rate for Payer: Cash Price |
$360.90
|
| Rate for Payer: Central Health Plan Commercial |
$641.60
|
| Rate for Payer: Cigna of CA HMO |
$513.28
|
| Rate for Payer: Cigna of CA PPO |
$593.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$681.70
|
| Rate for Payer: Dignity Health Media |
$681.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$681.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$320.80
|
| Rate for Payer: Galaxy Health WC |
$681.70
|
| Rate for Payer: Global Benefits Group Commercial |
$481.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$721.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$601.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$280.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$534.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$182.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$328.82
|
| Rate for Payer: Multiplan Commercial |
$601.50
|
| Rate for Payer: Networks By Design Commercial |
$521.30
|
| Rate for Payer: Prime Health Services Commercial |
$681.70
|
| Rate for Payer: Riverside University Health System MISP |
$320.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$481.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$481.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$681.70
|
| Rate for Payer: Vantage Medical Group Senior |
$681.70
|
|
|
HC EVAL RX SPEECH DVC 1ST HR MCAL
|
Facility
|
IP
|
$802.00
|
|
|
Service Code
|
CPT 92607
|
| Hospital Charge Code |
907000017
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$160.40 |
| Max. Negotiated Rate |
$721.80 |
| Rate for Payer: Cash Price |
$360.90
|
| Rate for Payer: Central Health Plan Commercial |
$641.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$320.80
|
| Rate for Payer: Galaxy Health WC |
$681.70
|
| Rate for Payer: Global Benefits Group Commercial |
$481.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$721.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$534.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$305.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$160.40
|
| Rate for Payer: Multiplan Commercial |
$601.50
|
| Rate for Payer: Networks By Design Commercial |
$521.30
|
| Rate for Payer: Prime Health Services Commercial |
$681.70
|
|
|
HC EVAL RX SPEECH DVC EA ADDL 30MIN MCAL
|
Facility
|
IP
|
$348.00
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
907000019
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$69.60 |
| Max. Negotiated Rate |
$313.20 |
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Central Health Plan Commercial |
$278.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$139.20
|
| Rate for Payer: Galaxy Health WC |
$295.80
|
| Rate for Payer: Global Benefits Group Commercial |
$208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$313.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$232.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$132.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$69.60
|
| Rate for Payer: Multiplan Commercial |
$261.00
|
| Rate for Payer: Networks By Design Commercial |
$226.20
|
| Rate for Payer: Prime Health Services Commercial |
$295.80
|
|
|
HC EVAL RX SPEECH DVC EA ADDL 30MIN MCAL
|
Facility
|
OP
|
$348.00
|
|
|
Service Code
|
CPT 92608
|
| Hospital Charge Code |
907000019
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$35.72 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$305.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$295.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$191.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$191.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$208.80
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Cash Price |
$156.60
|
| Rate for Payer: Central Health Plan Commercial |
$278.40
|
| Rate for Payer: Cigna of CA HMO |
$222.72
|
| Rate for Payer: Cigna of CA PPO |
$257.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.80
|
| Rate for Payer: Dignity Health Media |
$295.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$295.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$139.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$139.20
|
| Rate for Payer: Galaxy Health WC |
$295.80
|
| Rate for Payer: Global Benefits Group Commercial |
$208.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$313.20
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$261.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$121.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$232.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$142.68
|
| Rate for Payer: Multiplan Commercial |
$261.00
|
| Rate for Payer: Networks By Design Commercial |
$226.20
|
| Rate for Payer: Prime Health Services Commercial |
$295.80
|
| Rate for Payer: Riverside University Health System MISP |
$139.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$208.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$208.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$295.80
|
| Rate for Payer: Vantage Medical Group Senior |
$295.80
|
|
|
HC EVAL SPEECH FLUENCY
|
Facility
|
IP
|
$1,069.00
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
900100000
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$213.80 |
| Max. Negotiated Rate |
$962.10 |
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Central Health Plan Commercial |
$855.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$427.60
|
| Rate for Payer: Galaxy Health WC |
$908.65
|
| Rate for Payer: Global Benefits Group Commercial |
$641.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$962.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$713.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$407.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$213.80
|
| Rate for Payer: Multiplan Commercial |
$801.75
|
| Rate for Payer: Networks By Design Commercial |
$694.85
|
| Rate for Payer: Prime Health Services Commercial |
$908.65
|
|
|
HC EVAL SPEECH FLUENCY
|
Facility
|
OP
|
$1,069.00
|
|
|
Service Code
|
CPT 92521
|
| Hospital Charge Code |
900100000
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$142.46 |
| Max. Negotiated Rate |
$962.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$572.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$908.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$587.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$587.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$641.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Cash Price |
$481.05
|
| Rate for Payer: Central Health Plan Commercial |
$855.20
|
| Rate for Payer: Cigna of CA HMO |
$684.16
|
| Rate for Payer: Cigna of CA PPO |
$791.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$908.65
|
| Rate for Payer: Dignity Health Media |
$908.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$908.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$427.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$427.60
|
| Rate for Payer: Galaxy Health WC |
$908.65
|
| Rate for Payer: Global Benefits Group Commercial |
$641.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$962.10
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$801.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$374.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$713.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$142.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$438.29
|
| Rate for Payer: Multiplan Commercial |
$801.75
|
| Rate for Payer: Networks By Design Commercial |
$694.85
|
| Rate for Payer: Prime Health Services Commercial |
$908.65
|
| Rate for Payer: Riverside University Health System MISP |
$427.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$641.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$641.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$908.65
|
| Rate for Payer: Vantage Medical Group Senior |
$908.65
|
|
|
HC EVAL SPEECH/LANGUAGE/VOICE MCARE COMM
|
Facility
|
OP
|
$1,015.00
|
|
|
Service Code
|
CPT 92506
|
| Hospital Charge Code |
905601001
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$913.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$616.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$862.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$558.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$558.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$609.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$456.75
|
| Rate for Payer: Cash Price |
$456.75
|
| Rate for Payer: Cash Price |
$456.75
|
| Rate for Payer: Central Health Plan Commercial |
$812.00
|
| Rate for Payer: Cigna of CA HMO |
$649.60
|
| Rate for Payer: Cigna of CA PPO |
$751.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$862.75
|
| Rate for Payer: Dignity Health Media |
$862.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$862.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$406.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$406.00
|
| Rate for Payer: Galaxy Health WC |
$862.75
|
| Rate for Payer: Global Benefits Group Commercial |
$609.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$913.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$761.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$355.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$677.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$386.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$416.15
|
| Rate for Payer: Multiplan Commercial |
$761.25
|
| Rate for Payer: Networks By Design Commercial |
$659.75
|
| Rate for Payer: Prime Health Services Commercial |
$862.75
|
| Rate for Payer: Riverside University Health System MISP |
$406.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$609.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$609.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$862.75
|
| Rate for Payer: Vantage Medical Group Senior |
$862.75
|
|
|
HC EVAL SPEECH/LANGUAGE/VOICE MCARE COMM
|
Facility
|
IP
|
$1,015.00
|
|
|
Service Code
|
CPT 92506
|
| Hospital Charge Code |
905601001
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$203.00 |
| Max. Negotiated Rate |
$913.50 |
| Rate for Payer: Cash Price |
$456.75
|
| Rate for Payer: Central Health Plan Commercial |
$812.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$406.00
|
| Rate for Payer: Galaxy Health WC |
$862.75
|
| Rate for Payer: Global Benefits Group Commercial |
$609.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$913.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$677.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$386.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$203.00
|
| Rate for Payer: Multiplan Commercial |
$761.25
|
| Rate for Payer: Networks By Design Commercial |
$659.75
|
| Rate for Payer: Prime Health Services Commercial |
$862.75
|
|
|
HC EVAL SPEECH/LANGUAGE/VOICE PRELIM MCAL
|
Facility
|
IP
|
$1,102.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000021
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$220.40 |
| Max. Negotiated Rate |
$991.80 |
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Central Health Plan Commercial |
$881.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.80
|
| Rate for Payer: Galaxy Health WC |
$936.70
|
| Rate for Payer: Global Benefits Group Commercial |
$661.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$991.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$735.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$419.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$220.40
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Networks By Design Commercial |
$716.30
|
| Rate for Payer: Prime Health Services Commercial |
$936.70
|
|
|
HC EVAL SPEECH/LANGUAGE/VOICE PRELIM MCAL
|
Facility
|
OP
|
$1,102.00
|
|
|
Service Code
|
CPT 92507
|
| Hospital Charge Code |
907000021
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$56.47 |
| Max. Negotiated Rate |
$991.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$405.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$936.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$606.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$606.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$661.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Cash Price |
$495.90
|
| Rate for Payer: Central Health Plan Commercial |
$881.60
|
| Rate for Payer: Cigna of CA HMO |
$705.28
|
| Rate for Payer: Cigna of CA PPO |
$815.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$936.70
|
| Rate for Payer: Dignity Health Media |
$936.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$936.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$440.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$440.80
|
| Rate for Payer: Galaxy Health WC |
$936.70
|
| Rate for Payer: Global Benefits Group Commercial |
$661.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$991.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$826.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$385.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$735.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$451.82
|
| Rate for Payer: Multiplan Commercial |
$826.50
|
| Rate for Payer: Networks By Design Commercial |
$716.30
|
| Rate for Payer: Prime Health Services Commercial |
$936.70
|
| Rate for Payer: Riverside University Health System MISP |
$440.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$661.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$661.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$936.70
|
| Rate for Payer: Vantage Medical Group Senior |
$936.70
|
|
|
HC EVAL SPEECH SOUND PRODUCTION
|
Facility
|
OP
|
$860.00
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
900100001
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$102.30 |
| Max. Negotiated Rate |
$774.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$463.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$731.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$473.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$516.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Central Health Plan Commercial |
$688.00
|
| Rate for Payer: Cigna of CA HMO |
$550.40
|
| Rate for Payer: Cigna of CA PPO |
$636.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$731.00
|
| Rate for Payer: Dignity Health Media |
$731.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$731.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$344.00
|
| Rate for Payer: Galaxy Health WC |
$731.00
|
| Rate for Payer: Global Benefits Group Commercial |
$516.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$645.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$301.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$102.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$352.60
|
| Rate for Payer: Multiplan Commercial |
$645.00
|
| Rate for Payer: Networks By Design Commercial |
$559.00
|
| Rate for Payer: Prime Health Services Commercial |
$731.00
|
| Rate for Payer: Riverside University Health System MISP |
$344.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$731.00
|
| Rate for Payer: Vantage Medical Group Senior |
$731.00
|
|
|
HC EVAL SPEECH SOUND PRODUCTION
|
Facility
|
IP
|
$860.00
|
|
|
Service Code
|
CPT 92522
|
| Hospital Charge Code |
900100001
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$172.00 |
| Max. Negotiated Rate |
$774.00 |
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Central Health Plan Commercial |
$688.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.00
|
| Rate for Payer: Galaxy Health WC |
$731.00
|
| Rate for Payer: Global Benefits Group Commercial |
$516.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$327.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.00
|
| Rate for Payer: Multiplan Commercial |
$645.00
|
| Rate for Payer: Networks By Design Commercial |
$559.00
|
| Rate for Payer: Prime Health Services Commercial |
$731.00
|
|
|
HC EVAL SPEECH SOUND PROD W LANG COMP EXPRES
|
Facility
|
OP
|
$860.00
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
900100002
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$196.00 |
| Max. Negotiated Rate |
$964.23 |
| Rate for Payer: Aetna of CA HMO/PPO |
$964.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$731.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$473.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$473.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$516.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Central Health Plan Commercial |
$688.00
|
| Rate for Payer: Cigna of CA HMO |
$550.40
|
| Rate for Payer: Cigna of CA PPO |
$636.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$731.00
|
| Rate for Payer: Dignity Health Media |
$731.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$731.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$344.00
|
| Rate for Payer: Galaxy Health WC |
$731.00
|
| Rate for Payer: Global Benefits Group Commercial |
$516.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.00
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$645.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$301.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$248.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$352.60
|
| Rate for Payer: Multiplan Commercial |
$645.00
|
| Rate for Payer: Networks By Design Commercial |
$559.00
|
| Rate for Payer: Prime Health Services Commercial |
$731.00
|
| Rate for Payer: Riverside University Health System MISP |
$344.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$516.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$516.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$731.00
|
| Rate for Payer: Vantage Medical Group Senior |
$731.00
|
|
|
HC EVAL SPEECH SOUND PROD W LANG COMP EXPRES
|
Facility
|
IP
|
$860.00
|
|
|
Service Code
|
CPT 92523
|
| Hospital Charge Code |
900100002
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$172.00 |
| Max. Negotiated Rate |
$774.00 |
| Rate for Payer: Cash Price |
$387.00
|
| Rate for Payer: Central Health Plan Commercial |
$688.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$344.00
|
| Rate for Payer: Galaxy Health WC |
$731.00
|
| Rate for Payer: Global Benefits Group Commercial |
$516.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$774.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$573.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$327.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$172.00
|
| Rate for Payer: Multiplan Commercial |
$645.00
|
| Rate for Payer: Networks By Design Commercial |
$559.00
|
| Rate for Payer: Prime Health Services Commercial |
$731.00
|
|
|
HC EVAL SWALLOW/ORAL FUNC
|
Facility
|
OP
|
$1,095.00
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
905601753
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$92.68 |
| Max. Negotiated Rate |
$985.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$399.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$930.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$602.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$602.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$657.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Central Health Plan Commercial |
$876.00
|
| Rate for Payer: Cigna of CA HMO |
$700.80
|
| Rate for Payer: Cigna of CA PPO |
$810.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$930.75
|
| Rate for Payer: Dignity Health Media |
$930.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$930.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$438.00
|
| Rate for Payer: Galaxy Health WC |
$930.75
|
| Rate for Payer: Global Benefits Group Commercial |
$657.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$985.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$821.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$383.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$730.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.95
|
| Rate for Payer: Multiplan Commercial |
$821.25
|
| Rate for Payer: Networks By Design Commercial |
$711.75
|
| Rate for Payer: Prime Health Services Commercial |
$930.75
|
| Rate for Payer: Riverside University Health System MISP |
$438.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$657.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$657.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$930.75
|
| Rate for Payer: Vantage Medical Group Senior |
$930.75
|
|
|
HC EVAL SWALLOW/ORAL FUNC
|
Facility
|
IP
|
$1,095.00
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
905601753
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$219.00 |
| Max. Negotiated Rate |
$985.50 |
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Central Health Plan Commercial |
$876.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.00
|
| Rate for Payer: Galaxy Health WC |
$930.75
|
| Rate for Payer: Global Benefits Group Commercial |
$657.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$985.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$730.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$417.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.00
|
| Rate for Payer: Multiplan Commercial |
$821.25
|
| Rate for Payer: Networks By Design Commercial |
$711.75
|
| Rate for Payer: Prime Health Services Commercial |
$930.75
|
|
|
HC EVAL SWALLOW/ORAL FUNC MCAL
|
Facility
|
IP
|
$1,095.00
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
907000023
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$219.00 |
| Max. Negotiated Rate |
$985.50 |
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Central Health Plan Commercial |
$876.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.00
|
| Rate for Payer: Galaxy Health WC |
$930.75
|
| Rate for Payer: Global Benefits Group Commercial |
$657.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$985.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$730.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$417.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$219.00
|
| Rate for Payer: Multiplan Commercial |
$821.25
|
| Rate for Payer: Networks By Design Commercial |
$711.75
|
| Rate for Payer: Prime Health Services Commercial |
$930.75
|
|
|
HC EVAL SWALLOW/ORAL FUNC MCAL
|
Facility
|
OP
|
$1,095.00
|
|
|
Service Code
|
CPT 92610
|
| Hospital Charge Code |
907000023
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$92.68 |
| Max. Negotiated Rate |
$985.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$399.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$930.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$602.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$602.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$657.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Cash Price |
$492.75
|
| Rate for Payer: Central Health Plan Commercial |
$876.00
|
| Rate for Payer: Cigna of CA HMO |
$700.80
|
| Rate for Payer: Cigna of CA PPO |
$810.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$930.75
|
| Rate for Payer: Dignity Health Media |
$930.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$930.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$438.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$438.00
|
| Rate for Payer: Galaxy Health WC |
$930.75
|
| Rate for Payer: Global Benefits Group Commercial |
$657.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$985.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$821.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$383.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$730.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$92.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$448.95
|
| Rate for Payer: Multiplan Commercial |
$821.25
|
| Rate for Payer: Networks By Design Commercial |
$711.75
|
| Rate for Payer: Prime Health Services Commercial |
$930.75
|
| Rate for Payer: Riverside University Health System MISP |
$438.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$657.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$657.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$930.75
|
| Rate for Payer: Vantage Medical Group Senior |
$930.75
|
|
|
HC EVAL SWALLOW W RADIOLOGY MCAL
|
Facility
|
IP
|
$1,324.00
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
907000022
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$264.80 |
| Max. Negotiated Rate |
$1,191.60 |
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,059.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.60
|
| Rate for Payer: Galaxy Health WC |
$1,125.40
|
| Rate for Payer: Global Benefits Group Commercial |
$794.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,191.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$883.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$504.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$264.80
|
| Rate for Payer: Multiplan Commercial |
$993.00
|
| Rate for Payer: Networks By Design Commercial |
$860.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,125.40
|
|
|
HC EVAL SWALLOW W RADIOLOGY MCAL
|
Facility
|
OP
|
$1,324.00
|
|
|
Service Code
|
CPT 92611
|
| Hospital Charge Code |
907000022
|
|
Hospital Revenue Code
|
444
|
| Min. Negotiated Rate |
$75.90 |
| Max. Negotiated Rate |
$1,191.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$666.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,125.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$728.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$728.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$794.40
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Cash Price |
$595.80
|
| Rate for Payer: Central Health Plan Commercial |
$1,059.20
|
| Rate for Payer: Cigna of CA HMO |
$847.36
|
| Rate for Payer: Cigna of CA PPO |
$979.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1,125.40
|
| Rate for Payer: Dignity Health Media |
$1,125.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1,125.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$529.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$529.60
|
| Rate for Payer: Galaxy Health WC |
$1,125.40
|
| Rate for Payer: Global Benefits Group Commercial |
$794.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,191.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$993.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$463.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$883.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$75.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$542.84
|
| Rate for Payer: Multiplan Commercial |
$993.00
|
| Rate for Payer: Networks By Design Commercial |
$860.60
|
| Rate for Payer: Prime Health Services Commercial |
$1,125.40
|
| Rate for Payer: Riverside University Health System MISP |
$529.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$794.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$794.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1,125.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1,125.40
|
|
|
HC EVAL VOICE/AUG COMM DVC
|
Facility
|
IP
|
$952.00
|
|
|
Service Code
|
CPT 92597
|
| Hospital Charge Code |
905601812
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$190.40 |
| Max. Negotiated Rate |
$856.80 |
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Central Health Plan Commercial |
$761.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.80
|
| Rate for Payer: Galaxy Health WC |
$809.20
|
| Rate for Payer: Global Benefits Group Commercial |
$571.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$856.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$634.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$362.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$190.40
|
| Rate for Payer: Multiplan Commercial |
$714.00
|
| Rate for Payer: Networks By Design Commercial |
$618.80
|
| Rate for Payer: Prime Health Services Commercial |
$809.20
|
|
|
HC EVAL VOICE/AUG COMM DVC
|
Facility
|
OP
|
$952.00
|
|
|
Service Code
|
CPT 92597
|
| Hospital Charge Code |
905601812
|
|
Hospital Revenue Code
|
440
|
| Min. Negotiated Rate |
$155.59 |
| Max. Negotiated Rate |
$856.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$573.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$809.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$523.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$523.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$571.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Cash Price |
$428.40
|
| Rate for Payer: Central Health Plan Commercial |
$761.60
|
| Rate for Payer: Cigna of CA HMO |
$609.28
|
| Rate for Payer: Cigna of CA PPO |
$704.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$809.20
|
| Rate for Payer: Dignity Health Media |
$809.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$809.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$380.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$380.80
|
| Rate for Payer: Galaxy Health WC |
$809.20
|
| Rate for Payer: Global Benefits Group Commercial |
$571.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$856.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$714.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$333.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$634.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$155.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$390.32
|
| Rate for Payer: Multiplan Commercial |
$714.00
|
| Rate for Payer: Networks By Design Commercial |
$618.80
|
| Rate for Payer: Prime Health Services Commercial |
$809.20
|
| Rate for Payer: Riverside University Health System MISP |
$380.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$571.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$571.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$809.20
|
| Rate for Payer: Vantage Medical Group Senior |
$809.20
|
|
|
HC EVASC ST RPR THRC/AA ACRS BR
|
Facility
|
IP
|
$5,013.00
|
|
|
Service Code
|
CPT 33894
|
| Hospital Charge Code |
906820288
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,002.60 |
| Max. Negotiated Rate |
$4,511.70 |
| Rate for Payer: Cash Price |
$2,255.85
|
| Rate for Payer: Central Health Plan Commercial |
$4,010.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,005.20
|
| Rate for Payer: Galaxy Health WC |
$4,261.05
|
| Rate for Payer: Global Benefits Group Commercial |
$3,007.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,511.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3,343.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1,909.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,002.60
|
| Rate for Payer: Multiplan Commercial |
$3,759.75
|
| Rate for Payer: Networks By Design Commercial |
$3,258.45
|
| Rate for Payer: Prime Health Services Commercial |
$4,261.05
|
|
