|
HC SELECT WND DEBRIDE LT 20 SQ CM
|
Facility
|
OP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900501713
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$178.77 |
| Max. Negotiated Rate |
$2,901.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| 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: 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 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 |
$936.00
|
| 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: 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
|
|
|
HC SELECT WND DEBRIDE LT 20 SQ CM
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
903501026
|
|
Hospital Revenue Code
|
421
|
| 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 DEBRIDE LT 20 SQ CM
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900501713
|
|
Hospital Revenue Code
|
450
|
| 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 DEBRIDE LT 20 SQ CM
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900501713
|
|
Hospital Revenue Code
|
761
|
| 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 DEBRIDE LT 20 SQ CM
|
Facility
|
OP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
903501026
|
|
Hospital Revenue Code
|
421
|
| 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 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
|
|
|
HC SELECT WND DEBRIDE LT 20 SQ CM
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900501713
|
|
Hospital Revenue Code
|
516
|
| 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 DEBRIDE LT 20 SQ CM
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900501713
|
|
Hospital Revenue Code
|
720
|
| 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 DEBRIDE LT 20 SQ CM
|
Facility
|
OP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900501713
|
|
Hospital Revenue Code
|
720
|
| 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 |
$456.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$556.53
|
| 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 |
$1,036.00
|
| Rate for Payer: United Healthcare All Other HMO |
$799.00
|
| Rate for Payer: United Healthcare HMO Rider |
$605.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$552.00
|
| 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 LT 20 SQ CM COM
|
Facility
|
OP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900400059
|
|
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 LT 20 SQ CM COM
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900400059
|
|
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 DEBRIDE LT 20 SQ CM MCAL
|
Facility
|
OP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
901300070
|
|
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 DEBRIDE LT 20 SQ CM MCAL
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
901300070
|
|
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 DEBRIDE LT 20 SQ CM MCAL
|
Facility
|
OP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900400058
|
|
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 LT 20 SQ CM MCAL
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900400058
|
|
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 DEBRIDE LT 20 SQ CM PT
|
Facility
|
IP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900411300
|
|
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 DEBRIDE LT 20 SQ CM PT
|
Facility
|
OP
|
$942.00
|
|
|
Service Code
|
CPT 97597
|
| Hospital Charge Code |
900411300
|
|
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 SELF CARE/HOME MGT TRNG 15 MIN MCAL
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
901300066
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$52.20 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Central Health Plan Commercial |
$208.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.40
|
| Rate for Payer: Galaxy Health WC |
$221.85
|
| Rate for Payer: Global Benefits Group Commercial |
$156.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.20
|
| Rate for Payer: Multiplan Commercial |
$195.75
|
| Rate for Payer: Networks By Design Commercial |
$169.65
|
| Rate for Payer: Prime Health Services Commercial |
$221.85
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN MCAL
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
901300066
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$134.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$221.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$143.55
|
| 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 |
$156.60
|
| 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 |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Central Health Plan Commercial |
$208.80
|
| Rate for Payer: Cigna of CA HMO |
$167.04
|
| Rate for Payer: Cigna of CA PPO |
$193.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$221.85
|
| Rate for Payer: Dignity Health Media |
$221.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$221.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$104.40
|
| Rate for Payer: Galaxy Health WC |
$221.85
|
| Rate for Payer: Global Benefits Group Commercial |
$156.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$195.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$91.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.01
|
| Rate for Payer: Multiplan Commercial |
$195.75
|
| Rate for Payer: Networks By Design Commercial |
$169.65
|
| Rate for Payer: Prime Health Services Commercial |
$221.85
|
| Rate for Payer: Riverside University Health System MISP |
$104.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$156.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$156.60
|
| 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 |
$221.85
|
| Rate for Payer: Vantage Medical Group Senior |
$221.85
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN OT
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
905104363
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$52.20 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Central Health Plan Commercial |
$208.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.40
|
| Rate for Payer: Galaxy Health WC |
$221.85
|
| Rate for Payer: Global Benefits Group Commercial |
$156.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.20
|
| Rate for Payer: Multiplan Commercial |
$195.75
|
| Rate for Payer: Networks By Design Commercial |
$169.65
|
| Rate for Payer: Prime Health Services Commercial |
$221.85
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN OT
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
905104363
|
|
Hospital Revenue Code
|
430
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$134.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$221.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$143.55
|
| 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 |
$156.60
|
| 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 |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Central Health Plan Commercial |
$208.80
|
| Rate for Payer: Cigna of CA HMO |
$167.04
|
| Rate for Payer: Cigna of CA PPO |
$193.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$221.85
|
| Rate for Payer: Dignity Health Media |
$221.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$221.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$104.40
|
| Rate for Payer: Galaxy Health WC |
$221.85
|
| Rate for Payer: Global Benefits Group Commercial |
$156.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$195.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$91.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.01
|
| Rate for Payer: Multiplan Commercial |
$195.75
|
| Rate for Payer: Networks By Design Commercial |
$169.65
|
| Rate for Payer: Prime Health Services Commercial |
$221.85
|
| Rate for Payer: Riverside University Health System MISP |
$104.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$156.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$156.60
|
| 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 |
$221.85
|
| Rate for Payer: Vantage Medical Group Senior |
$221.85
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN PT
|
Facility
|
IP
|
$261.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
900419056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$52.20 |
| Max. Negotiated Rate |
$234.90 |
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Central Health Plan Commercial |
$208.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.40
|
| Rate for Payer: Galaxy Health WC |
$221.85
|
| Rate for Payer: Global Benefits Group Commercial |
$156.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$99.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.20
|
| Rate for Payer: Multiplan Commercial |
$195.75
|
| Rate for Payer: Networks By Design Commercial |
$169.65
|
| Rate for Payer: Prime Health Services Commercial |
$221.85
|
|
|
HC SELF CARE/HOME MGT TRNG 15 MIN PT
|
Facility
|
OP
|
$261.00
|
|
|
Service Code
|
CPT 97535
|
| Hospital Charge Code |
900419056
|
|
Hospital Revenue Code
|
420
|
| Min. Negotiated Rate |
$10.09 |
| Max. Negotiated Rate |
$408.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$134.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$221.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$143.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$143.55
|
| 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 |
$156.60
|
| 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 |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Cash Price |
$117.45
|
| Rate for Payer: Central Health Plan Commercial |
$208.80
|
| Rate for Payer: Cigna of CA HMO |
$167.04
|
| Rate for Payer: Cigna of CA PPO |
$193.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$221.85
|
| Rate for Payer: Dignity Health Media |
$221.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$221.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$104.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$104.40
|
| Rate for Payer: Galaxy Health WC |
$221.85
|
| Rate for Payer: Global Benefits Group Commercial |
$156.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$234.90
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$195.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$91.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$174.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$107.01
|
| Rate for Payer: Multiplan Commercial |
$195.75
|
| Rate for Payer: Networks By Design Commercial |
$169.65
|
| Rate for Payer: Prime Health Services Commercial |
$221.85
|
| Rate for Payer: Riverside University Health System MISP |
$104.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$156.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$156.60
|
| 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 |
$221.85
|
| Rate for Payer: Vantage Medical Group Senior |
$221.85
|
|
|
HC SELLA TURCICA
|
Facility
|
OP
|
$663.00
|
|
|
Service Code
|
CPT 70240
|
| Hospital Charge Code |
909001114
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$41.08 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$113.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$113.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$113.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$107.89
|
| Rate for Payer: Blue Distinction Transplant |
$397.80
|
| Rate for Payer: Blue Shield of California Commercial |
$409.73
|
| Rate for Payer: Blue Shield of California EPN |
$322.22
|
| Rate for Payer: Caremore Medicare Advantage |
$113.54
|
| Rate for Payer: Cash Price |
$298.35
|
| Rate for Payer: Cash Price |
$298.35
|
| Rate for Payer: Central Health Plan Commercial |
$530.40
|
| Rate for Payer: Cigna of CA HMO |
$424.32
|
| Rate for Payer: Cigna of CA PPO |
$490.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$170.31
|
| Rate for Payer: Dignity Health Media |
$113.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$153.28
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$113.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$113.54
|
| Rate for Payer: Galaxy Health WC |
$563.55
|
| Rate for Payer: Global Benefits Group Commercial |
$397.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$596.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$497.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$186.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$187.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$113.54
|
| Rate for Payer: InnovAge PACE Commercial |
$170.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$442.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.08
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$113.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$152.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$152.14
|
| Rate for Payer: Multiplan Commercial |
$497.25
|
| Rate for Payer: Networks By Design Commercial |
$430.95
|
| Rate for Payer: Prime Health Services Commercial |
$563.55
|
| Rate for Payer: Prime Health Services Medicare |
$120.35
|
| Rate for Payer: Riverside University Health System MISP |
$124.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$397.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$397.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$114.69
|
| Rate for Payer: United Healthcare All Other HMO |
$114.69
|
| Rate for Payer: United Healthcare HMO Rider |
$114.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$114.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$170.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.89
|
| Rate for Payer: Vantage Medical Group Senior |
$113.54
|
|
|
HC SELLA TURCICA
|
Facility
|
IP
|
$663.00
|
|
|
Service Code
|
CPT 70240
|
| Hospital Charge Code |
909001114
|
|
Hospital Revenue Code
|
320
|
| Min. Negotiated Rate |
$132.60 |
| Max. Negotiated Rate |
$596.70 |
| Rate for Payer: Cash Price |
$298.35
|
| Rate for Payer: Central Health Plan Commercial |
$530.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$265.20
|
| Rate for Payer: Galaxy Health WC |
$563.55
|
| Rate for Payer: Global Benefits Group Commercial |
$397.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$596.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$442.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$252.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$132.60
|
| Rate for Payer: Multiplan Commercial |
$497.25
|
| Rate for Payer: Networks By Design Commercial |
$430.95
|
| Rate for Payer: Prime Health Services Commercial |
$563.55
|
|
