|
HC PSYCH DIAGNOSTIC EVALUATION
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
950900000
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Senior |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.00
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
|
|
HC PSYCHIATRIC DIAGNOSTIC EVAL
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
900100712
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$120.60 |
| Max. Negotiated Rate |
$542.70 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$482.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$241.20
|
| Rate for Payer: EPIC Health Plan Senior |
$241.20
|
| Rate for Payer: Galaxy Health WC |
$512.55
|
| Rate for Payer: Global Benefits Group Commercial |
$361.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$542.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$402.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$229.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$373.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.60
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: Networks By Design Commercial |
$391.95
|
| Rate for Payer: Prime Health Services Commercial |
$512.55
|
|
|
HC PSYCHIATRIC DIAGNOSTIC EVAL
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
900100712
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$120.60 |
| Max. Negotiated Rate |
$542.70 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$204.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$366.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$291.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$354.14
|
| Rate for Payer: Blue Shield of California Commercial |
$368.43
|
| Rate for Payer: Blue Shield of California EPN |
$240.60
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$482.40
|
| Rate for Payer: Cigna of CA HMO |
$385.92
|
| Rate for Payer: Cigna of CA PPO |
$446.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$306.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.60
|
| Rate for Payer: EPIC Health Plan Senior |
$204.15
|
| Rate for Payer: Galaxy Health WC |
$512.55
|
| Rate for Payer: Global Benefits Group Commercial |
$361.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$542.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$334.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$220.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$204.15
|
| Rate for Payer: InnovAge PACE Commercial |
$306.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$402.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$243.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$273.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$273.56
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: Networks By Design Commercial |
$391.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$204.15
|
| Rate for Payer: Prime Health Services Commercial |
$512.55
|
| Rate for Payer: Prime Health Services Medicare |
$216.40
|
| Rate for Payer: Riverside University Health System MISP |
$224.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$361.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$361.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$301.50
|
| Rate for Payer: United Healthcare All Other HMO |
$301.50
|
| Rate for Payer: United Healthcare HMO Rider |
$301.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$301.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$204.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Vantage Medical Group Senior |
$204.15
|
|
|
HC PSYCHIATRIC DIAGNOSTIC EVAL
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
900100712
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$120.60 |
| Max. Negotiated Rate |
$542.70 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$482.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$241.20
|
| Rate for Payer: EPIC Health Plan Senior |
$241.20
|
| Rate for Payer: Galaxy Health WC |
$512.55
|
| Rate for Payer: Global Benefits Group Commercial |
$361.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$542.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$402.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$229.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$373.26
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: Networks By Design Commercial |
$391.95
|
| Rate for Payer: Prime Health Services Commercial |
$512.55
|
|
|
HC PSYCHIATRIC DIAGNOSTIC EVAL
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
CPT 90791
|
| Hospital Charge Code |
900100712
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$120.60 |
| Max. Negotiated Rate |
$542.70 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$204.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$366.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$291.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$354.14
|
| Rate for Payer: Blue Shield of California Commercial |
$368.43
|
| Rate for Payer: Blue Shield of California EPN |
$240.60
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$482.40
|
| Rate for Payer: Cigna of CA HMO |
$385.92
|
| Rate for Payer: Cigna of CA PPO |
$446.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$306.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.60
|
| Rate for Payer: EPIC Health Plan Senior |
$204.15
|
| Rate for Payer: Galaxy Health WC |
$512.55
|
| Rate for Payer: Global Benefits Group Commercial |
$361.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$542.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$334.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$220.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$204.15
|
| Rate for Payer: InnovAge PACE Commercial |
$306.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$402.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$243.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$273.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$273.56
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: Networks By Design Commercial |
$391.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$204.15
|
| Rate for Payer: Prime Health Services Commercial |
$512.55
|
| Rate for Payer: Prime Health Services Medicare |
$216.40
|
| Rate for Payer: Riverside University Health System MISP |
$224.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$361.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$361.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$301.50
|
| Rate for Payer: United Healthcare All Other HMO |
$301.50
|
| Rate for Payer: United Healthcare HMO Rider |
$301.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$301.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$204.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Vantage Medical Group Senior |
$204.15
|
|
|
HC PSYCHIATRIC SERVICE OR PROC
|
Facility
|
OP
|
$483.00
|
|
|
Service Code
|
CPT 90899
|
| Hospital Charge Code |
900100713
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$37.85 |
| Max. Negotiated Rate |
$1,570.00 |
| Rate for Payer: Adventist Health Commercial |
$96.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$37.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$293.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$41.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$233.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$283.67
|
| Rate for Payer: Blue Shield of California Commercial |
$295.11
|
| Rate for Payer: Blue Shield of California EPN |
$192.72
|
| Rate for Payer: Cash Price |
$265.65
|
| Rate for Payer: Cash Price |
$265.65
|
| Rate for Payer: Cash Price |
$265.65
|
| Rate for Payer: Central Health Plan Commercial |
$386.40
|
| Rate for Payer: Cigna of CA HMO |
$309.12
|
| Rate for Payer: Cigna of CA PPO |
$357.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.10
|
| Rate for Payer: EPIC Health Plan Senior |
$37.85
|
| Rate for Payer: Galaxy Health WC |
$410.55
|
| Rate for Payer: Global Benefits Group Commercial |
$289.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$62.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37.85
|
| Rate for Payer: InnovAge PACE Commercial |
$56.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$50.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50.72
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
| Rate for Payer: Networks By Design Commercial |
$313.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$37.85
|
| Rate for Payer: Prime Health Services Commercial |
$410.55
|
| Rate for Payer: Prime Health Services Medicare |
$40.12
|
| Rate for Payer: Riverside University Health System MISP |
$41.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$289.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$289.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,570.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,496.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,129.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,035.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$37.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.63
|
| Rate for Payer: Vantage Medical Group Senior |
$37.85
|
|
|
HC PSYCHIATRIC SERVICE OR PROC
|
Facility
|
IP
|
$483.00
|
|
|
Service Code
|
CPT 90899
|
| Hospital Charge Code |
900100713
|
|
Hospital Revenue Code
|
900
|
| Min. Negotiated Rate |
$96.60 |
| Max. Negotiated Rate |
$434.70 |
| Rate for Payer: Adventist Health Commercial |
$96.60
|
| Rate for Payer: Cash Price |
$265.65
|
| Rate for Payer: Central Health Plan Commercial |
$386.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$193.20
|
| Rate for Payer: EPIC Health Plan Senior |
$193.20
|
| Rate for Payer: Galaxy Health WC |
$410.55
|
| Rate for Payer: Global Benefits Group Commercial |
$289.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$298.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.60
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
| Rate for Payer: Networks By Design Commercial |
$313.95
|
| Rate for Payer: Prime Health Services Commercial |
$410.55
|
|
|
HC PSYCHOTHERAPY 30 MIN W PT
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
900100700
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$58.00 |
| Max. Negotiated Rate |
$334.81 |
| Rate for Payer: Adventist Health Commercial |
$58.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$204.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$176.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.32
|
| Rate for Payer: Blue Shield of California Commercial |
$177.19
|
| Rate for Payer: Blue Shield of California EPN |
$115.71
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Central Health Plan Commercial |
$232.00
|
| Rate for Payer: Cigna of CA HMO |
$185.60
|
| Rate for Payer: Cigna of CA PPO |
$214.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$306.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.60
|
| Rate for Payer: EPIC Health Plan Senior |
$204.15
|
| Rate for Payer: Galaxy Health WC |
$246.50
|
| Rate for Payer: Global Benefits Group Commercial |
$174.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$334.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$90.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$204.15
|
| Rate for Payer: InnovAge PACE Commercial |
$306.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$193.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$273.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$273.56
|
| Rate for Payer: Multiplan Commercial |
$217.50
|
| Rate for Payer: Networks By Design Commercial |
$188.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$204.15
|
| Rate for Payer: Prime Health Services Commercial |
$246.50
|
| Rate for Payer: Prime Health Services Medicare |
$216.40
|
| Rate for Payer: Riverside University Health System MISP |
$224.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$174.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$174.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.00
|
| Rate for Payer: United Healthcare All Other HMO |
$145.00
|
| Rate for Payer: United Healthcare HMO Rider |
$145.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$204.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Vantage Medical Group Senior |
$204.15
|
|
|
HC PSYCHOTHERAPY 30 MIN W PT
|
Facility
|
OP
|
$290.00
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
900100700
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$58.00 |
| Max. Negotiated Rate |
$334.81 |
| Rate for Payer: Adventist Health Commercial |
$58.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$204.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$176.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$140.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$170.32
|
| Rate for Payer: Blue Shield of California Commercial |
$177.19
|
| Rate for Payer: Blue Shield of California EPN |
$115.71
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Central Health Plan Commercial |
$232.00
|
| Rate for Payer: Cigna of CA HMO |
$185.60
|
| Rate for Payer: Cigna of CA PPO |
$214.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$306.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.60
|
| Rate for Payer: EPIC Health Plan Senior |
$204.15
|
| Rate for Payer: Galaxy Health WC |
$246.50
|
| Rate for Payer: Global Benefits Group Commercial |
$174.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$334.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$90.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$204.15
|
| Rate for Payer: InnovAge PACE Commercial |
$306.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$193.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$273.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$273.56
|
| Rate for Payer: Multiplan Commercial |
$217.50
|
| Rate for Payer: Networks By Design Commercial |
$188.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$204.15
|
| Rate for Payer: Prime Health Services Commercial |
$246.50
|
| Rate for Payer: Prime Health Services Medicare |
$216.40
|
| Rate for Payer: Riverside University Health System MISP |
$224.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$174.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$174.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$145.00
|
| Rate for Payer: United Healthcare All Other HMO |
$145.00
|
| Rate for Payer: United Healthcare HMO Rider |
$145.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$145.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$204.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Vantage Medical Group Senior |
$204.15
|
|
|
HC PSYCHOTHERAPY 30 MIN W PT
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
900100700
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$58.00 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Adventist Health Commercial |
$58.00
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Central Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.00
|
| Rate for Payer: EPIC Health Plan Senior |
$116.00
|
| Rate for Payer: Galaxy Health WC |
$246.50
|
| Rate for Payer: Global Benefits Group Commercial |
$174.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$193.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$179.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$58.00
|
| Rate for Payer: Multiplan Commercial |
$217.50
|
| Rate for Payer: Networks By Design Commercial |
$188.50
|
| Rate for Payer: Prime Health Services Commercial |
$246.50
|
|
|
HC PSYCHOTHERAPY 30 MIN W PT
|
Facility
|
IP
|
$290.00
|
|
|
Service Code
|
CPT 90832
|
| Hospital Charge Code |
900100700
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$58.00 |
| Max. Negotiated Rate |
$261.00 |
| Rate for Payer: Adventist Health Commercial |
$58.00
|
| Rate for Payer: Cash Price |
$159.50
|
| Rate for Payer: Central Health Plan Commercial |
$232.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$116.00
|
| Rate for Payer: EPIC Health Plan Senior |
$116.00
|
| Rate for Payer: Galaxy Health WC |
$246.50
|
| Rate for Payer: Global Benefits Group Commercial |
$174.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$261.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$193.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$110.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$179.51
|
| Rate for Payer: Multiplan Commercial |
$217.50
|
| Rate for Payer: Networks By Design Commercial |
$188.50
|
| Rate for Payer: Prime Health Services Commercial |
$246.50
|
|
|
HC PSYCHOTHERAPY 45 MIN W PT
|
Facility
|
OP
|
$483.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
900100701
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$96.60 |
| Max. Negotiated Rate |
$434.70 |
| Rate for Payer: Adventist Health Commercial |
$96.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$204.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$293.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$233.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$283.67
|
| Rate for Payer: Blue Shield of California Commercial |
$295.11
|
| Rate for Payer: Blue Shield of California EPN |
$192.72
|
| Rate for Payer: Cash Price |
$265.65
|
| Rate for Payer: Cash Price |
$265.65
|
| Rate for Payer: Central Health Plan Commercial |
$386.40
|
| Rate for Payer: Cigna of CA HMO |
$309.12
|
| Rate for Payer: Cigna of CA PPO |
$357.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$306.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.60
|
| Rate for Payer: EPIC Health Plan Senior |
$204.15
|
| Rate for Payer: Galaxy Health WC |
$410.55
|
| Rate for Payer: Global Benefits Group Commercial |
$289.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$334.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$115.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$204.15
|
| Rate for Payer: InnovAge PACE Commercial |
$306.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$273.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$273.56
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
| Rate for Payer: Networks By Design Commercial |
$313.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$204.15
|
| Rate for Payer: Prime Health Services Commercial |
$410.55
|
| Rate for Payer: Prime Health Services Medicare |
$216.40
|
| Rate for Payer: Riverside University Health System MISP |
$224.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$289.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$289.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$241.50
|
| Rate for Payer: United Healthcare All Other HMO |
$241.50
|
| Rate for Payer: United Healthcare HMO Rider |
$241.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$241.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$204.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Vantage Medical Group Senior |
$204.15
|
|
|
HC PSYCHOTHERAPY 45 MIN W PT
|
Facility
|
IP
|
$483.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
900100701
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$96.60 |
| Max. Negotiated Rate |
$434.70 |
| Rate for Payer: Adventist Health Commercial |
$96.60
|
| Rate for Payer: Cash Price |
$265.65
|
| Rate for Payer: Central Health Plan Commercial |
$386.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$193.20
|
| Rate for Payer: EPIC Health Plan Senior |
$193.20
|
| Rate for Payer: Galaxy Health WC |
$410.55
|
| Rate for Payer: Global Benefits Group Commercial |
$289.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$298.98
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
| Rate for Payer: Networks By Design Commercial |
$313.95
|
| Rate for Payer: Prime Health Services Commercial |
$410.55
|
|
|
HC PSYCHOTHERAPY 45 MIN W PT
|
Facility
|
IP
|
$483.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
900100701
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$96.60 |
| Max. Negotiated Rate |
$434.70 |
| Rate for Payer: Adventist Health Commercial |
$96.60
|
| Rate for Payer: Cash Price |
$265.65
|
| Rate for Payer: Central Health Plan Commercial |
$386.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$193.20
|
| Rate for Payer: EPIC Health Plan Senior |
$193.20
|
| Rate for Payer: Galaxy Health WC |
$410.55
|
| Rate for Payer: Global Benefits Group Commercial |
$289.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$184.02
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$298.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.60
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
| Rate for Payer: Networks By Design Commercial |
$313.95
|
| Rate for Payer: Prime Health Services Commercial |
$410.55
|
|
|
HC PSYCHOTHERAPY 45 MIN W PT
|
Facility
|
OP
|
$483.00
|
|
|
Service Code
|
CPT 90834
|
| Hospital Charge Code |
900100701
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$96.60 |
| Max. Negotiated Rate |
$434.70 |
| Rate for Payer: Adventist Health Commercial |
$96.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$204.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$293.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$233.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$283.67
|
| Rate for Payer: Blue Shield of California Commercial |
$295.11
|
| Rate for Payer: Blue Shield of California EPN |
$192.72
|
| Rate for Payer: Cash Price |
$265.65
|
| Rate for Payer: Cash Price |
$265.65
|
| Rate for Payer: Central Health Plan Commercial |
$386.40
|
| Rate for Payer: Cigna of CA HMO |
$309.12
|
| Rate for Payer: Cigna of CA PPO |
$357.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$306.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.60
|
| Rate for Payer: EPIC Health Plan Senior |
$204.15
|
| Rate for Payer: Galaxy Health WC |
$410.55
|
| Rate for Payer: Global Benefits Group Commercial |
$289.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$434.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$334.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$115.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$204.15
|
| Rate for Payer: InnovAge PACE Commercial |
$306.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$322.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$127.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$273.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$273.56
|
| Rate for Payer: Multiplan Commercial |
$362.25
|
| Rate for Payer: Networks By Design Commercial |
$313.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$204.15
|
| Rate for Payer: Prime Health Services Commercial |
$410.55
|
| Rate for Payer: Prime Health Services Medicare |
$216.40
|
| Rate for Payer: Riverside University Health System MISP |
$224.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$289.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$289.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$241.50
|
| Rate for Payer: United Healthcare All Other HMO |
$241.50
|
| Rate for Payer: United Healthcare HMO Rider |
$241.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$241.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$204.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Vantage Medical Group Senior |
$204.15
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
900100702
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$120.60 |
| Max. Negotiated Rate |
$542.70 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$204.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$366.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$291.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$354.14
|
| Rate for Payer: Blue Shield of California Commercial |
$368.43
|
| Rate for Payer: Blue Shield of California EPN |
$240.60
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$482.40
|
| Rate for Payer: Cigna of CA HMO |
$385.92
|
| Rate for Payer: Cigna of CA PPO |
$446.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$306.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.60
|
| Rate for Payer: EPIC Health Plan Senior |
$204.15
|
| Rate for Payer: Galaxy Health WC |
$512.55
|
| Rate for Payer: Global Benefits Group Commercial |
$361.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$542.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$334.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$168.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$204.15
|
| Rate for Payer: InnovAge PACE Commercial |
$306.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$402.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$186.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$273.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$273.56
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: Networks By Design Commercial |
$391.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$204.15
|
| Rate for Payer: Prime Health Services Commercial |
$512.55
|
| Rate for Payer: Prime Health Services Medicare |
$216.40
|
| Rate for Payer: Riverside University Health System MISP |
$224.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$361.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$361.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$301.50
|
| Rate for Payer: United Healthcare All Other HMO |
$301.50
|
| Rate for Payer: United Healthcare HMO Rider |
$301.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$301.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$204.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Vantage Medical Group Senior |
$204.15
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
900100702
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$120.60 |
| Max. Negotiated Rate |
$542.70 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$482.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$241.20
|
| Rate for Payer: EPIC Health Plan Senior |
$241.20
|
| Rate for Payer: Galaxy Health WC |
$512.55
|
| Rate for Payer: Global Benefits Group Commercial |
$361.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$542.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$402.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$229.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$373.26
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: Networks By Design Commercial |
$391.95
|
| Rate for Payer: Prime Health Services Commercial |
$512.55
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
IP
|
$603.00
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
900100702
|
|
Hospital Revenue Code
|
510
|
| Min. Negotiated Rate |
$120.60 |
| Max. Negotiated Rate |
$542.70 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$482.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$241.20
|
| Rate for Payer: EPIC Health Plan Senior |
$241.20
|
| Rate for Payer: Galaxy Health WC |
$512.55
|
| Rate for Payer: Global Benefits Group Commercial |
$361.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$542.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$402.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$229.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$373.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.60
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: Networks By Design Commercial |
$391.95
|
| Rate for Payer: Prime Health Services Commercial |
$512.55
|
|
|
HC PSYCHOTHERAPY 60 MIN W PT
|
Facility
|
OP
|
$603.00
|
|
|
Service Code
|
CPT 90837
|
| Hospital Charge Code |
900100702
|
|
Hospital Revenue Code
|
914
|
| Min. Negotiated Rate |
$120.60 |
| Max. Negotiated Rate |
$542.70 |
| Rate for Payer: Adventist Health Commercial |
$120.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$204.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$366.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$204.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$291.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$354.14
|
| Rate for Payer: Blue Shield of California Commercial |
$368.43
|
| Rate for Payer: Blue Shield of California EPN |
$240.60
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Cash Price |
$331.65
|
| Rate for Payer: Central Health Plan Commercial |
$482.40
|
| Rate for Payer: Cigna of CA HMO |
$385.92
|
| Rate for Payer: Cigna of CA PPO |
$446.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$306.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$204.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$275.60
|
| Rate for Payer: EPIC Health Plan Senior |
$204.15
|
| Rate for Payer: Galaxy Health WC |
$512.55
|
| Rate for Payer: Global Benefits Group Commercial |
$361.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$542.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$334.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$168.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$204.15
|
| Rate for Payer: InnovAge PACE Commercial |
$306.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$402.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$186.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$204.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$273.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$273.56
|
| Rate for Payer: Multiplan Commercial |
$452.25
|
| Rate for Payer: Networks By Design Commercial |
$391.95
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$204.15
|
| Rate for Payer: Prime Health Services Commercial |
$512.55
|
| Rate for Payer: Prime Health Services Medicare |
$216.40
|
| Rate for Payer: Riverside University Health System MISP |
$224.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$361.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$361.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$301.50
|
| Rate for Payer: United Healthcare All Other HMO |
$301.50
|
| Rate for Payer: United Healthcare HMO Rider |
$301.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$301.50
|
| Rate for Payer: Upland Medical Group Pediatric |
$204.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$306.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.56
|
| Rate for Payer: Vantage Medical Group Senior |
$204.15
|
|
|
HC PSYCH TESTING
|
Facility
|
IP
|
$150.00
|
|
|
Service Code
|
CPT 96100
|
| Hospital Charge Code |
907804040
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$135.00 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Senior |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.85
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
|
|
HC PSYCH TESTING
|
Facility
|
OP
|
$150.00
|
|
|
Service Code
|
CPT 96100
|
| Hospital Charge Code |
907804040
|
|
Hospital Revenue Code
|
912
|
| Min. Negotiated Rate |
$30.00 |
| Max. Negotiated Rate |
$800.00 |
| Rate for Payer: Adventist Health Commercial |
$30.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$127.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$82.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$112.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$72.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$88.09
|
| Rate for Payer: Blue Shield of California Commercial |
$91.65
|
| Rate for Payer: Blue Shield of California EPN |
$59.85
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Cash Price |
$82.50
|
| Rate for Payer: Central Health Plan Commercial |
$120.00
|
| Rate for Payer: Cigna of CA HMO |
$96.00
|
| Rate for Payer: Cigna of CA PPO |
$111.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$127.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$127.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$127.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$60.00
|
| Rate for Payer: EPIC Health Plan Senior |
$60.00
|
| Rate for Payer: Galaxy Health WC |
$127.50
|
| Rate for Payer: Global Benefits Group Commercial |
$90.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$135.00
|
| Rate for Payer: Health Net Behavioral |
$800.00
|
| Rate for Payer: InnovAge PACE Commercial |
$75.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$100.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$57.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$92.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$105.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$105.00
|
| Rate for Payer: Multiplan Commercial |
$112.50
|
| Rate for Payer: Networks By Design Commercial |
$97.50
|
| Rate for Payer: Prime Health Services Commercial |
$127.50
|
| Rate for Payer: Riverside University Health System MISP |
$60.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$90.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$90.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$75.00
|
| Rate for Payer: United Healthcare All Other HMO |
$75.00
|
| Rate for Payer: United Healthcare HMO Rider |
$75.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$75.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$127.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$127.50
|
| Rate for Payer: Vantage Medical Group Senior |
$127.50
|
|
|
HC PTA FEM/POP
|
Facility
|
IP
|
$15,314.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
906820148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$3,062.80 |
| Max. Negotiated Rate |
$13,782.60 |
| Rate for Payer: Adventist Health Commercial |
$3,062.80
|
| Rate for Payer: Cash Price |
$8,422.70
|
| Rate for Payer: Central Health Plan Commercial |
$12,251.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,125.60
|
| Rate for Payer: EPIC Health Plan Senior |
$6,125.60
|
| Rate for Payer: Galaxy Health WC |
$13,016.90
|
| Rate for Payer: Global Benefits Group Commercial |
$9,188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,782.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,214.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,834.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9,479.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,062.80
|
| Rate for Payer: Multiplan Commercial |
$11,485.50
|
| Rate for Payer: Networks By Design Commercial |
$9,954.10
|
| Rate for Payer: Prime Health Services Commercial |
$13,016.90
|
|
|
HC PTA FEM/POP
|
Facility
|
OP
|
$15,314.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
906820148
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$669.82 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$3,062.80
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,244.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,244.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,542.58
|
| Rate for Payer: Blue Shield of California Commercial |
$5,999.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$8,422.70
|
| Rate for Payer: Cash Price |
$8,422.70
|
| Rate for Payer: Cash Price |
$8,422.70
|
| Rate for Payer: Central Health Plan Commercial |
$12,251.20
|
| Rate for Payer: Cigna of CA HMO |
$9,800.96
|
| Rate for Payer: Cigna of CA PPO |
$11,332.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,968.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,244.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,779.87
|
| Rate for Payer: EPIC Health Plan Senior |
$7,244.35
|
| Rate for Payer: Galaxy Health WC |
$13,016.90
|
| Rate for Payer: Global Benefits Group Commercial |
$9,188.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$13,782.60
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,880.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$669.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,244.35
|
| Rate for Payer: InnovAge PACE Commercial |
$10,866.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10,214.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$739.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,244.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3,062.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,707.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,707.43
|
| Rate for Payer: Multiplan Commercial |
$11,485.50
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$9,954.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,244.35
|
| Rate for Payer: Preferred Health Network WC |
$11,778.14
|
| Rate for Payer: Prime Health Services Commercial |
$13,016.90
|
| Rate for Payer: Prime Health Services Medicare |
$7,679.01
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Riverside University Health System MISP |
$7,968.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9,188.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,244.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Vantage Medical Group Senior |
$7,244.35
|
|
|
HC PTA FEM/POP
|
Facility
|
IP
|
$13,017.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
909020065
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,603.40 |
| Max. Negotiated Rate |
$11,715.30 |
| Rate for Payer: Adventist Health Commercial |
$2,603.40
|
| Rate for Payer: Cash Price |
$7,159.35
|
| Rate for Payer: Central Health Plan Commercial |
$10,413.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,206.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5,206.80
|
| Rate for Payer: Galaxy Health WC |
$11,064.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,810.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,715.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,682.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,959.48
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8,057.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,603.40
|
| Rate for Payer: Multiplan Commercial |
$9,762.75
|
| Rate for Payer: Networks By Design Commercial |
$8,461.05
|
| Rate for Payer: Prime Health Services Commercial |
$11,064.45
|
|
|
HC PTA FEM/POP
|
Facility
|
OP
|
$13,017.00
|
|
|
Service Code
|
CPT 37224
|
| Hospital Charge Code |
909020065
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$669.82 |
| Max. Negotiated Rate |
$28,817.00 |
| Rate for Payer: Adventist Health Commercial |
$2,603.40
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,244.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,244.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,419.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,581.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,542.58
|
| Rate for Payer: Blue Shield of California Commercial |
$5,999.40
|
| Rate for Payer: Blue Shield of California EPN |
$3,914.40
|
| Rate for Payer: Cash Price |
$7,159.35
|
| Rate for Payer: Cash Price |
$7,159.35
|
| Rate for Payer: Cash Price |
$7,159.35
|
| Rate for Payer: Central Health Plan Commercial |
$10,413.60
|
| Rate for Payer: Cigna of CA HMO |
$8,330.88
|
| Rate for Payer: Cigna of CA PPO |
$9,632.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,968.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,244.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9,779.87
|
| Rate for Payer: EPIC Health Plan Senior |
$7,244.35
|
| Rate for Payer: Galaxy Health WC |
$11,064.45
|
| Rate for Payer: Global Benefits Group Commercial |
$7,810.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,715.30
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$11,880.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$669.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,244.35
|
| Rate for Payer: InnovAge PACE Commercial |
$10,866.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,682.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$739.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7,244.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,603.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9,707.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9,707.43
|
| Rate for Payer: Multiplan Commercial |
$9,762.75
|
| Rate for Payer: Multiplan WC |
$11,542.58
|
| Rate for Payer: Networks By Design Commercial |
$8,461.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,244.35
|
| Rate for Payer: Preferred Health Network WC |
$11,778.14
|
| Rate for Payer: Prime Health Services Commercial |
$11,064.45
|
| Rate for Payer: Prime Health Services Medicare |
$7,679.01
|
| Rate for Payer: Prime Health Services WC |
$11,424.80
|
| Rate for Payer: Riverside University Health System MISP |
$7,968.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,810.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$17,712.00
|
| Rate for Payer: United Healthcare All Other HMO |
$28,817.00
|
| Rate for Payer: United Healthcare HMO Rider |
$18,075.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16,561.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,244.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10,866.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,968.78
|
| Rate for Payer: Vantage Medical Group Senior |
$7,244.35
|
|
