|
HC SELECT CATH L/R PULMONARY ART
|
Facility
|
IP
|
$584.00
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
909081312
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.80 |
| Max. Negotiated Rate |
$525.60 |
| Rate for Payer: Cash Price |
$262.80
|
| Rate for Payer: Central Health Plan Commercial |
$467.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.60
|
| Rate for Payer: Galaxy Health WC |
$496.40
|
| Rate for Payer: Global Benefits Group Commercial |
$350.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$525.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$389.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$222.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.80
|
| Rate for Payer: Multiplan Commercial |
$438.00
|
| Rate for Payer: Networks By Design Commercial |
$379.60
|
| Rate for Payer: Prime Health Services Commercial |
$496.40
|
|
|
HC SELECT CATH L/R PULMONARY ART
|
Facility
|
IP
|
$584.00
|
|
|
Service Code
|
CPT 36014
|
| Hospital Charge Code |
906820171
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.80 |
| Max. Negotiated Rate |
$525.60 |
| Rate for Payer: Cash Price |
$262.80
|
| Rate for Payer: Central Health Plan Commercial |
$467.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.60
|
| Rate for Payer: Galaxy Health WC |
$496.40
|
| Rate for Payer: Global Benefits Group Commercial |
$350.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$525.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$389.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$222.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.80
|
| Rate for Payer: Multiplan Commercial |
$438.00
|
| Rate for Payer: Networks By Design Commercial |
$379.60
|
| Rate for Payer: Prime Health Services Commercial |
$496.40
|
|
|
HC SELECT CATH PULMON. ART SEGMENTAL
|
Facility
|
IP
|
$584.00
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
906820172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.80 |
| Max. Negotiated Rate |
$525.60 |
| Rate for Payer: Cash Price |
$262.80
|
| Rate for Payer: Central Health Plan Commercial |
$467.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.60
|
| Rate for Payer: Galaxy Health WC |
$496.40
|
| Rate for Payer: Global Benefits Group Commercial |
$350.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$525.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$389.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$222.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.80
|
| Rate for Payer: Multiplan Commercial |
$438.00
|
| Rate for Payer: Networks By Design Commercial |
$379.60
|
| Rate for Payer: Prime Health Services Commercial |
$496.40
|
|
|
HC SELECT CATH PULMON. ART SEGMENTAL
|
Facility
|
OP
|
$584.00
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
906820172
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.80 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$496.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$321.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$321.20
|
| 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 Distinction Transplant |
$350.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$262.80
|
| Rate for Payer: Cash Price |
$262.80
|
| Rate for Payer: Cash Price |
$262.80
|
| Rate for Payer: Central Health Plan Commercial |
$467.20
|
| Rate for Payer: Cigna of CA PPO |
$432.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$496.40
|
| Rate for Payer: Dignity Health Media |
$496.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$496.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$233.60
|
| Rate for Payer: Galaxy Health WC |
$496.40
|
| Rate for Payer: Global Benefits Group Commercial |
$350.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$525.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$438.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$204.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$389.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$215.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.80
|
| Rate for Payer: Multiplan Commercial |
$438.00
|
| Rate for Payer: Networks By Design Commercial |
$379.60
|
| Rate for Payer: Prime Health Services Commercial |
$496.40
|
| Rate for Payer: Riverside University Health System MISP |
$233.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$350.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$496.40
|
| Rate for Payer: Vantage Medical Group Senior |
$496.40
|
|
|
HC SELECT CATH PULMON. ART SEGMENTAL
|
Facility
|
OP
|
$584.00
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
909081313
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.80 |
| Max. Negotiated Rate |
$7,609.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$496.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$321.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$321.20
|
| 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 Distinction Transplant |
$350.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Cash Price |
$262.80
|
| Rate for Payer: Cash Price |
$262.80
|
| Rate for Payer: Cash Price |
$262.80
|
| Rate for Payer: Central Health Plan Commercial |
$467.20
|
| Rate for Payer: Cigna of CA PPO |
$432.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$496.40
|
| Rate for Payer: Dignity Health Media |
$496.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$496.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.60
|
| Rate for Payer: EPIC Health Plan Transplant |
$233.60
|
| Rate for Payer: Galaxy Health WC |
$496.40
|
| Rate for Payer: Global Benefits Group Commercial |
$350.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$525.60
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$438.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$204.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$389.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$215.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.80
|
| Rate for Payer: Multiplan Commercial |
$438.00
|
| Rate for Payer: Networks By Design Commercial |
$379.60
|
| Rate for Payer: Prime Health Services Commercial |
$496.40
|
| Rate for Payer: Riverside University Health System MISP |
$233.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$350.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$496.40
|
| Rate for Payer: Vantage Medical Group Senior |
$496.40
|
|
|
HC SELECT CATH PULMON. ART SEGMENTAL
|
Facility
|
IP
|
$584.00
|
|
|
Service Code
|
CPT 36015
|
| Hospital Charge Code |
909081313
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$116.80 |
| Max. Negotiated Rate |
$525.60 |
| Rate for Payer: Cash Price |
$262.80
|
| Rate for Payer: Central Health Plan Commercial |
$467.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$233.60
|
| Rate for Payer: Galaxy Health WC |
$496.40
|
| Rate for Payer: Global Benefits Group Commercial |
$350.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$525.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$389.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$222.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$116.80
|
| Rate for Payer: Multiplan Commercial |
$438.00
|
| Rate for Payer: Networks By Design Commercial |
$379.60
|
| Rate for Payer: Prime Health Services Commercial |
$496.40
|
|
|
HC SELECT WND DBRD LT 20 SQ CM OT
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
905101300
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$188.40 |
| Max. Negotiated Rate |
$847.80 |
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Central Health Plan Commercial |
$753.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.80
|
| Rate for Payer: Galaxy Health WC |
$800.70
|
| Rate for Payer: Global Benefits Group Commercial |
$565.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$847.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$628.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.40
|
| Rate for Payer: Multiplan Commercial |
$706.50
|
| Rate for Payer: Networks By Design Commercial |
$612.30
|
| Rate for Payer: Prime Health Services Commercial |
$800.70
|
|
|
HC SELECT WND DBRD LT 20 SQ CM OT
|
Facility
|
OP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
905101300
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$178.77 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$565.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Central Health Plan Commercial |
$753.60
|
| Rate for Payer: Cigna of CA HMO |
$602.88
|
| Rate for Payer: Cigna of CA PPO |
$697.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$800.70
|
| Rate for Payer: Global Benefits Group Commercial |
$565.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$847.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$706.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$628.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$386.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$706.50
|
| Rate for Payer: Networks By Design Commercial |
$612.30
|
| Rate for Payer: Prime Health Services Commercial |
$800.70
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$565.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC SELECT WND DEBRD LT 20SQ CM PT
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
905101303
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$188.40 |
| Max. Negotiated Rate |
$847.80 |
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Central Health Plan Commercial |
$753.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$376.80
|
| Rate for Payer: Galaxy Health WC |
$800.70
|
| Rate for Payer: Global Benefits Group Commercial |
$565.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$847.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$628.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$358.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.40
|
| Rate for Payer: Multiplan Commercial |
$706.50
|
| Rate for Payer: Networks By Design Commercial |
$612.30
|
| Rate for Payer: Prime Health Services Commercial |
$800.70
|
|
|
HC SELECT WND DEBRD LT 20SQ CM PT
|
Facility
|
OP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
905101303
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$178.77 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$565.20
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Central Health Plan Commercial |
$753.60
|
| Rate for Payer: Cigna of CA HMO |
$602.88
|
| Rate for Payer: Cigna of CA PPO |
$697.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$800.70
|
| Rate for Payer: Global Benefits Group Commercial |
$565.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$847.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$706.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$628.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$386.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$706.50
|
| Rate for Payer: Networks By Design Commercial |
$612.30
|
| Rate for Payer: Prime Health Services Commercial |
$800.70
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$565.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM
|
Facility
|
OP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
903501030
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$101.59 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$939.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$607.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$663.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Cigna of CA HMO |
$707.20
|
| Rate for Payer: Cigna of CA PPO |
$817.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$939.25
|
| Rate for Payer: Dignity Health Media |
$939.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$939.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$828.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.05
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
| Rate for Payer: Riverside University Health System MISP |
$442.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$663.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$939.25
|
| Rate for Payer: Vantage Medical Group Senior |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM
|
Facility
|
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
903501030
|
|
Hospital Revenue Code
|
421
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$421.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM MCAL
|
Facility
|
OP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
900400060
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$101.59 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$939.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$607.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$663.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Cigna of CA HMO |
$707.20
|
| Rate for Payer: Cigna of CA PPO |
$817.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$939.25
|
| Rate for Payer: Dignity Health Media |
$939.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$939.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$828.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.05
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
| Rate for Payer: Riverside University Health System MISP |
$442.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$663.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$939.25
|
| Rate for Payer: Vantage Medical Group Senior |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM MCAL
|
Facility
|
OP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
901300072
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$101.59 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$939.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$607.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$663.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Cigna of CA HMO |
$707.20
|
| Rate for Payer: Cigna of CA PPO |
$817.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$939.25
|
| Rate for Payer: Dignity Health Media |
$939.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$939.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$828.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.05
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
| Rate for Payer: Riverside University Health System MISP |
$442.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$663.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$939.25
|
| Rate for Payer: Vantage Medical Group Senior |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM MCAL
|
Facility
|
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
900400060
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$421.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM MCAL
|
Facility
|
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
901300072
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$421.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM OT
|
Facility
|
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
905101301
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$421.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM OT
|
Facility
|
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
905101301
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$421.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM OT
|
Facility
|
OP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
905101301
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$101.59 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$939.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$607.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$535.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$652.83
|
| Rate for Payer: Blue Distinction Transplant |
$663.00
|
| Rate for Payer: Blue Shield of California Commercial |
$695.04
|
| Rate for Payer: Blue Shield of California EPN |
$540.34
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Cigna of CA HMO |
$707.20
|
| Rate for Payer: Cigna of CA PPO |
$817.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$939.25
|
| Rate for Payer: Dignity Health Media |
$939.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$939.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$828.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
| Rate for Payer: Riverside University Health System MISP |
$442.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$663.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$552.50
|
| Rate for Payer: United Healthcare All Other HMO |
$552.50
|
| Rate for Payer: United Healthcare HMO Rider |
$552.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$939.25
|
| Rate for Payer: Vantage Medical Group Senior |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM OT
|
Facility
|
OP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
905101301
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$101.59 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$939.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$607.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$663.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Cigna of CA HMO |
$707.20
|
| Rate for Payer: Cigna of CA PPO |
$817.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$939.25
|
| Rate for Payer: Dignity Health Media |
$939.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$939.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$828.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.05
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
| Rate for Payer: Riverside University Health System MISP |
$442.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$663.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$939.25
|
| Rate for Payer: Vantage Medical Group Senior |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM PT
|
Facility
|
OP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
905101304
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$101.59 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$939.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$607.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$663.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Cigna of CA HMO |
$707.20
|
| Rate for Payer: Cigna of CA PPO |
$817.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$939.25
|
| Rate for Payer: Dignity Health Media |
$939.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$939.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$828.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.05
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
| Rate for Payer: Riverside University Health System MISP |
$442.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$663.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$939.25
|
| Rate for Payer: Vantage Medical Group Senior |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM PT
|
Facility
|
OP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
900411301
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$101.59 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$939.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$607.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$607.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$336.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$408.00
|
| Rate for Payer: Blue Distinction Transplant |
$663.00
|
| Rate for Payer: Blue Shield of California Commercial |
$400.00
|
| Rate for Payer: Blue Shield of California EPN |
$287.00
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: Cigna of CA HMO |
$707.20
|
| Rate for Payer: Cigna of CA PPO |
$817.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$939.25
|
| Rate for Payer: Dignity Health Media |
$939.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$939.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$828.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$386.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$101.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$453.05
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
| Rate for Payer: Riverside University Health System MISP |
$442.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$663.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$396.00
|
| Rate for Payer: United Healthcare All Other HMO |
$281.00
|
| Rate for Payer: United Healthcare HMO Rider |
$213.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$196.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$939.25
|
| Rate for Payer: Vantage Medical Group Senior |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM PT
|
Facility
|
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
900411301
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$421.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
|
|
HC SELECT WND DEBRIDE GT 20 SQ CM PT
|
Facility
|
IP
|
$1,105.00
|
|
|
Service Code
|
CPT 97598
|
| Hospital Charge Code |
905101304
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$221.00 |
| Max. Negotiated Rate |
$994.50 |
| Rate for Payer: Cash Price |
$497.25
|
| Rate for Payer: Central Health Plan Commercial |
$884.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$442.00
|
| Rate for Payer: Galaxy Health WC |
$939.25
|
| Rate for Payer: Global Benefits Group Commercial |
$663.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$994.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$737.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$421.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$221.00
|
| Rate for Payer: Multiplan Commercial |
$828.75
|
| Rate for Payer: Networks By Design Commercial |
$718.25
|
| Rate for Payer: Prime Health Services Commercial |
$939.25
|
|
|
HC SELECT WND DEBRIDE LT 20 SQ CM
|
Facility
|
OP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900501713
|
|
Hospital Revenue Code
|
516
|
| Min. Negotiated Rate |
$178.77 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$250.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$250.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: Blue Distinction Transplant |
$565.20
|
| Rate for Payer: Blue Shield of California Commercial |
$592.52
|
| Rate for Payer: Blue Shield of California EPN |
$460.64
|
| Rate for Payer: Caremore Medicare Advantage |
$250.14
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Cash Price |
$423.90
|
| Rate for Payer: Central Health Plan Commercial |
$753.60
|
| Rate for Payer: Cigna of CA HMO |
$602.88
|
| Rate for Payer: Cigna of CA PPO |
$697.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$375.21
|
| Rate for Payer: Dignity Health Media |
$250.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$275.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$337.69
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$250.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$250.14
|
| Rate for Payer: Galaxy Health WC |
$800.70
|
| Rate for Payer: Global Benefits Group Commercial |
$565.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$847.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$706.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$410.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$412.73
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$250.14
|
| Rate for Payer: InnovAge PACE Commercial |
$375.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$628.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$178.77
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$250.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$188.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$335.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$335.19
|
| Rate for Payer: Multiplan Commercial |
$706.50
|
| Rate for Payer: Networks By Design Commercial |
$612.30
|
| Rate for Payer: Prime Health Services Commercial |
$800.70
|
| Rate for Payer: Prime Health Services Medicare |
$265.15
|
| Rate for Payer: Riverside University Health System MISP |
$275.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$565.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$225.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$471.00
|
| Rate for Payer: United Healthcare All Other HMO |
$471.00
|
| Rate for Payer: United Healthcare HMO Rider |
$471.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$471.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$375.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$275.15
|
| Rate for Payer: Vantage Medical Group Senior |
$250.14
|
|
