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California rates for HCPCS G0469

Federally Qualified Health Center (FQHC) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving a mental health visit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.15 / $110.15 / $110.15
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.15 / $142.26 / $142.26
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$664.54 / $706.91 / $735.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $66.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$198.00 / $323.00 / $801.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$76.00 / $100.00 / $100.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $60.00 / $85.00
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$110.15 / $129.43 / $144.30
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $1,800,000.00