Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.5 cm or less
|
Facility
|
OP
|
$6,248.00
|
|
Service Code
|
CPT 11440
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$122.38 |
Max. Negotiated Rate |
$6,248.00 |
Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
Rate for Payer: Caremore Medicare Advantage |
$879.07
|
Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
Rate for Payer: Dignity Health Media |
$879.07
|
Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$122.38
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
Rate for Payer: Prime Health Services Medicare |
$931.81
|
Rate for Payer: Riverside University Health System MISP |
$966.98
|
Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 0.6 to 1.0 cm
|
Facility
|
OP
|
$6,248.00
|
|
Service Code
|
CPT 11441
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$307.57 |
Max. Negotiated Rate |
$6,248.00 |
Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
Rate for Payer: Caremore Medicare Advantage |
$879.07
|
Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
Rate for Payer: Dignity Health Media |
$879.07
|
Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$307.57
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
Rate for Payer: Prime Health Services Medicare |
$931.81
|
Rate for Payer: Riverside University Health System MISP |
$966.98
|
Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 1.1 to 2.0 cm
|
Facility
|
OP
|
$5,779.00
|
|
Service Code
|
CPT 11442
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$152.08 |
Max. Negotiated Rate |
$5,779.00 |
Rate for Payer: Adventist Health Medi-Cal |
$879.07
|
Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1,318.60
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$966.98
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$879.07
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
Rate for Payer: Caremore Medicare Advantage |
$879.07
|
Rate for Payer: Dignity Health Commercial/Exchange |
$1,318.60
|
Rate for Payer: Dignity Health Media |
$879.07
|
Rate for Payer: Dignity Health Medi-Cal |
$966.98
|
Rate for Payer: EPIC Health Plan Commercial |
$1,186.74
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$879.07
|
Rate for Payer: EPIC Health Plan Transplant |
$879.07
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$1,441.67
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,450.47
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$879.07
|
Rate for Payer: InnovAge PACE Commercial |
$1,318.60
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$152.08
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$879.07
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1,177.95
|
Rate for Payer: Molina Healthcare of CA Medicare |
$1,177.95
|
Rate for Payer: Prime Health Services Medicare |
$931.81
|
Rate for Payer: Riverside University Health System MISP |
$966.98
|
Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1,318.60
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$966.98
|
Rate for Payer: Vantage Medical Group Senior |
$879.07
|
|
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 2.1 to 3.0 cm
|
Facility
|
OP
|
$5,779.00
|
|
Service Code
|
CPT 11443
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$400.03 |
Max. Negotiated Rate |
$5,779.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$400.03
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter 3.1 to 4.0 cm
|
Facility
|
OP
|
$5,779.00
|
|
Service Code
|
CPT 11444
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$233.43 |
Max. Negotiated Rate |
$5,779.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$3,079.84
|
Rate for Payer: Blue Shield of California EPN |
$2,212.08
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$233.43
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, other benign lesion including margins, except skin tag (unless listed elsewhere), face, ears, eyelids, nose, lips, mucous membrane; excised diameter over 4.0 cm
|
Facility
|
OP
|
$15,354.00
|
|
Service Code
|
CPT 11446
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$662.64 |
Max. Negotiated Rate |
$15,354.00 |
Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
Rate for Payer: Dignity Health Media |
$3,550.26
|
Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$662.64
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
Excision, radial head
|
Facility
|
OP
|
$19,907.00
|
|
Service Code
|
CPT 24130
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$128.04 |
Max. Negotiated Rate |
$19,907.00 |
Rate for Payer: Adventist Health Medi-Cal |
$4,044.21
|
Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,066.32
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,448.63
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,044.21
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
Rate for Payer: Caremore Medicare Advantage |
$4,044.21
|
Rate for Payer: Dignity Health Commercial/Exchange |
$6,066.32
|
Rate for Payer: Dignity Health Media |
$4,044.21
|
Rate for Payer: Dignity Health Medi-Cal |
$4,448.63
|
Rate for Payer: EPIC Health Plan Commercial |
$5,459.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$4,044.21
|
Rate for Payer: EPIC Health Plan Transplant |
$4,044.21
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,632.50
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,672.95
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,044.21
|
Rate for Payer: InnovAge PACE Commercial |
$6,066.32
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$128.04
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,044.21
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,419.24
|
Rate for Payer: Molina Healthcare of CA Medicare |
$5,419.24
|
Rate for Payer: Prime Health Services Medicare |
$4,286.86
|
Rate for Payer: Riverside University Health System MISP |
$4,448.63
|
Rate for Payer: United Healthcare All Other Commercial |
$13,537.00
|
Rate for Payer: United Healthcare All Other HMO |
$19,907.00
|
Rate for Payer: United Healthcare HMO Rider |
$12,444.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$11,379.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,066.32
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$4,448.63
|
Rate for Payer: Vantage Medical Group Senior |
$4,044.21
|
|
Excision soft tissue lesion, external auditory canal
|
Facility
|
OP
|
$7,027.00
|
|
Service Code
|
CPT 69145
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$343.08 |
Max. Negotiated Rate |
$7,027.00 |
Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
Rate for Payer: Dignity Health Media |
$3,550.26
|
Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$343.08
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; 1.5 cm or greater
|
Facility
|
OP
|
$15,354.00
|
|
Service Code
|
CPT 26111
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$130.15 |
Max. Negotiated Rate |
$15,354.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$130.15
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, tumor or vascular malformation, soft tissue of hand or finger, subcutaneous; less than 1.5 cm
|
Facility
|
OP
|
$7,027.00
|
|
Service Code
|
CPT 26115
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$338.12 |
Max. Negotiated Rate |
$7,027.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$338.12
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, tumor, soft tissue of abdominal wall, subcutaneous; 3 cm or greater
|
Facility
|
OP
|
$15,354.00
|
|
Service Code
|
CPT 22903
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$137.94 |
Max. Negotiated Rate |
$15,354.00 |
Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
Rate for Payer: Dignity Health Media |
$3,550.26
|
Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$137.94
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
Excision, tumor, soft tissue of back or flank, subcutaneous; 3 cm or greater
|
Facility
|
OP
|
$15,354.00
|
|
Service Code
|
CPT 21931
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$146.43 |
Max. Negotiated Rate |
$15,354.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$146.43
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, tumor, soft tissue of back or flank, subcutaneous; less than 3 cm
|
Facility
|
OP
|
$7,084.00
|
|
Service Code
|
CPT 21930
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$705.24 |
Max. Negotiated Rate |
$7,084.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$705.24
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, tumor, soft tissue of back or flank, subfascial (eg, intramuscular); 5 cm or greater
|
Facility
|
OP
|
$15,354.00
|
|
Service Code
|
CPT 21933
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$231.31 |
Max. Negotiated Rate |
$15,354.00 |
Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
Rate for Payer: Dignity Health Media |
$3,550.26
|
Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$231.31
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
Excision, tumor, soft tissue of face and scalp, subfascial (eg, subgaleal, intramuscular); 2 cm or greater
|
Facility
|
OP
|
$5,857.93
|
|
Service Code
|
CPT 21014
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$164.10 |
Max. Negotiated Rate |
$5,857.93 |
Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
Rate for Payer: Dignity Health Media |
$3,550.26
|
Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$164.10
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
Excision, tumor, soft tissue of face or scalp, subcutaneous; 2 cm or greater
|
Facility
|
OP
|
$5,779.00
|
|
Service Code
|
CPT 21012
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$106.82 |
Max. Negotiated Rate |
$5,779.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.82
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, tumor, soft tissue of face or scalp, subcutaneous; less than 2 cm
|
Facility
|
OP
|
$4,846.00
|
|
Service Code
|
CPT 21011
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$512.85 |
Max. Negotiated Rate |
$4,846.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$512.85
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$4,121.00
|
Rate for Payer: United Healthcare All Other HMO |
$4,248.00
|
Rate for Payer: United Healthcare HMO Rider |
$2,468.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$2,257.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, tumor, soft tissue of foot or toe, subcutaneous; 1.5 cm or greater
|
Facility
|
OP
|
$15,354.00
|
|
Service Code
|
CPT 28039
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$771.23 |
Max. Negotiated Rate |
$15,354.00 |
Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
Rate for Payer: Dignity Health Media |
$3,550.26
|
Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$771.23
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
Excision, tumor, soft tissue of forearm and/or wrist area, subcutaneous; less than 3 cm
|
Facility
|
OP
|
$7,027.00
|
|
Service Code
|
CPT 25075
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$124.49 |
Max. Negotiated Rate |
$7,027.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$124.49
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); 3 cm or greater
|
Facility
|
OP
|
$15,354.00
|
|
Service Code
|
CPT 25073
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$834.69 |
Max. Negotiated Rate |
$15,354.00 |
Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
Rate for Payer: Dignity Health Media |
$3,550.26
|
Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$834.69
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
Excision, tumor, soft tissue of forearm and/or wrist area, subfascial (eg, intramuscular); less than 3 cm
|
Facility
|
OP
|
$8,114.00
|
|
Service Code
|
CPT 25076
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$326.34 |
Max. Negotiated Rate |
$8,114.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$326.34
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; 3 cm or greater
|
Facility
|
OP
|
$15,354.00
|
|
Service Code
|
CPT 21552
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$703.13 |
Max. Negotiated Rate |
$15,354.00 |
Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
Rate for Payer: Dignity Health Media |
$3,550.26
|
Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$703.13
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
Excision, tumor, soft tissue of neck or anterior thorax, subcutaneous; less than 3 cm
|
Facility
|
OP
|
$7,027.00
|
|
Service Code
|
CPT 21555
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$628.84 |
Max. Negotiated Rate |
$7,027.00 |
Rate for Payer: Adventist Health Medi-Cal |
$2,025.69
|
Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,025.69
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$2,025.69
|
Rate for Payer: Dignity Health Commercial/Exchange |
$3,038.54
|
Rate for Payer: Dignity Health Media |
$2,025.69
|
Rate for Payer: Dignity Health Medi-Cal |
$2,228.26
|
Rate for Payer: EPIC Health Plan Commercial |
$2,734.68
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,025.69
|
Rate for Payer: EPIC Health Plan Transplant |
$2,025.69
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,322.13
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3,342.39
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,025.69
|
Rate for Payer: InnovAge PACE Commercial |
$3,038.54
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$628.84
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,025.69
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,714.42
|
Rate for Payer: Molina Healthcare of CA Medicare |
$2,714.42
|
Rate for Payer: Prime Health Services Medicare |
$2,147.23
|
Rate for Payer: Riverside University Health System MISP |
$2,228.26
|
Rate for Payer: United Healthcare All Other Commercial |
$5,893.00
|
Rate for Payer: United Healthcare All Other HMO |
$7,027.00
|
Rate for Payer: United Healthcare HMO Rider |
$4,217.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$3,918.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,038.54
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$2,228.26
|
Rate for Payer: Vantage Medical Group Senior |
$2,025.69
|
|
Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); 5 cm or greater
|
Facility
|
OP
|
$15,354.00
|
|
Service Code
|
CPT 21554
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$229.90 |
Max. Negotiated Rate |
$15,354.00 |
Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
Rate for Payer: Aetna of CA HMO/PPO |
$8,114.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,710.35
|
Rate for Payer: Blue Shield of California EPN |
$3,383.18
|
Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
Rate for Payer: Dignity Health Media |
$3,550.26
|
Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$229.90
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|
Excision, tumor, soft tissue of neck or anterior thorax, subfascial (eg, intramuscular); less than 5 cm
|
Facility
|
OP
|
$15,354.00
|
|
Service Code
|
CPT 21556
|
Hospital Revenue Code
|
360
|
Min. Negotiated Rate |
$151.37 |
Max. Negotiated Rate |
$15,354.00 |
Rate for Payer: Adventist Health Medi-Cal |
$3,550.26
|
Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3,550.26
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
Rate for Payer: Caremore Medicare Advantage |
$3,550.26
|
Rate for Payer: Dignity Health Commercial/Exchange |
$5,325.39
|
Rate for Payer: Dignity Health Media |
$3,550.26
|
Rate for Payer: Dignity Health Medi-Cal |
$3,905.29
|
Rate for Payer: EPIC Health Plan Commercial |
$4,792.85
|
Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,550.26
|
Rate for Payer: EPIC Health Plan Transplant |
$3,550.26
|
Rate for Payer: Heritage Provider Network Commercial/Senior |
$5,822.43
|
Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,857.93
|
Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$3,550.26
|
Rate for Payer: InnovAge PACE Commercial |
$5,325.39
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$151.37
|
Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,550.26
|
Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4,757.35
|
Rate for Payer: Molina Healthcare of CA Medicare |
$4,757.35
|
Rate for Payer: Prime Health Services Medicare |
$3,763.28
|
Rate for Payer: Riverside University Health System MISP |
$3,905.29
|
Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,325.39
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$3,905.29
|
Rate for Payer: Vantage Medical Group Senior |
$3,550.26
|
|