|
HC SUTURE CHROMIC 3-0 CT2 104504
|
Facility
|
OP
|
$33.21
|
|
| Hospital Charge Code |
901694620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.64 |
| Max. Negotiated Rate |
$28.23 |
| Rate for Payer: Adventist Health Commercial |
$6.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.39
|
| Rate for Payer: Cash Price |
$14.94
|
| Rate for Payer: Cigna of CA HMO |
$21.25
|
| Rate for Payer: Cigna of CA PPO |
$24.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.28
|
| Rate for Payer: EPIC Health Plan Senior |
$13.28
|
| Rate for Payer: Galaxy Health WC |
$28.23
|
| Rate for Payer: Global Benefits Group Commercial |
$19.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.25
|
| Rate for Payer: Multiplan Commercial |
$26.57
|
| Rate for Payer: Networks By Design Commercial |
$21.59
|
| Rate for Payer: Prime Health Services Commercial |
$28.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.61
|
| Rate for Payer: United Healthcare All Other HMO |
$16.61
|
| Rate for Payer: United Healthcare HMO Rider |
$16.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.23
|
| Rate for Payer: Vantage Medical Group Senior |
$28.23
|
|
|
HC SUTURE CHROMIC 4-0 FS-2 635G
|
Facility
|
IP
|
$16.81
|
|
| Hospital Charge Code |
901693117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$14.29 |
| Rate for Payer: Adventist Health Commercial |
$3.36
|
| Rate for Payer: Cash Price |
$7.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.72
|
| Rate for Payer: EPIC Health Plan Senior |
$6.72
|
| Rate for Payer: Galaxy Health WC |
$14.29
|
| Rate for Payer: Global Benefits Group Commercial |
$10.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.03
|
| Rate for Payer: Multiplan Commercial |
$13.45
|
| Rate for Payer: Networks By Design Commercial |
$10.93
|
| Rate for Payer: Prime Health Services Commercial |
$14.29
|
|
|
HC SUTURE CHROMIC 4-0 FS-2 635G
|
Facility
|
OP
|
$16.81
|
|
| Hospital Charge Code |
901693117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$14.29 |
| Rate for Payer: Adventist Health Commercial |
$3.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.32
|
| Rate for Payer: Cash Price |
$7.56
|
| Rate for Payer: Cigna of CA HMO |
$10.76
|
| Rate for Payer: Cigna of CA PPO |
$12.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.72
|
| Rate for Payer: EPIC Health Plan Senior |
$6.72
|
| Rate for Payer: Galaxy Health WC |
$14.29
|
| Rate for Payer: Global Benefits Group Commercial |
$10.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.77
|
| Rate for Payer: Multiplan Commercial |
$13.45
|
| Rate for Payer: Networks By Design Commercial |
$10.93
|
| Rate for Payer: Prime Health Services Commercial |
$14.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.40
|
| Rate for Payer: United Healthcare All Other HMO |
$8.40
|
| Rate for Payer: United Healthcare HMO Rider |
$8.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.29
|
| Rate for Payer: Vantage Medical Group Senior |
$14.29
|
|
|
HC SUTURE CHROMIC 4-0 PS-2
|
Facility
|
IP
|
$576.35
|
|
| Hospital Charge Code |
901694888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.27 |
| Max. Negotiated Rate |
$489.90 |
| Rate for Payer: Adventist Health Commercial |
$115.27
|
| Rate for Payer: Cash Price |
$259.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.54
|
| Rate for Payer: EPIC Health Plan Senior |
$230.54
|
| Rate for Payer: Galaxy Health WC |
$489.90
|
| Rate for Payer: Global Benefits Group Commercial |
$345.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$384.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$356.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.32
|
| Rate for Payer: Multiplan Commercial |
$461.08
|
| Rate for Payer: Networks By Design Commercial |
$374.63
|
| Rate for Payer: Prime Health Services Commercial |
$489.90
|
|
|
HC SUTURE CHROMIC 4-0 PS-2
|
Facility
|
OP
|
$576.35
|
|
| Hospital Charge Code |
901694888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.27 |
| Max. Negotiated Rate |
$489.90 |
| Rate for Payer: Adventist Health Commercial |
$115.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$378.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$489.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$316.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$432.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$353.94
|
| Rate for Payer: Cash Price |
$259.36
|
| Rate for Payer: Cigna of CA HMO |
$368.86
|
| Rate for Payer: Cigna of CA PPO |
$426.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$489.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$489.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$489.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.54
|
| Rate for Payer: EPIC Health Plan Senior |
$230.54
|
| Rate for Payer: Galaxy Health WC |
$489.90
|
| Rate for Payer: Global Benefits Group Commercial |
$345.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$384.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$356.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$138.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$403.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$403.44
|
| Rate for Payer: Multiplan Commercial |
$461.08
|
| Rate for Payer: Networks By Design Commercial |
$374.63
|
| Rate for Payer: Prime Health Services Commercial |
$489.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$345.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$345.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$288.18
|
| Rate for Payer: United Healthcare All Other HMO |
$288.18
|
| Rate for Payer: United Healthcare HMO Rider |
$288.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$288.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$489.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$489.90
|
| Rate for Payer: Vantage Medical Group Senior |
$489.90
|
|
|
HC SUTURE CHROMIC CT-2 100063
|
Facility
|
IP
|
$21.24
|
|
| Hospital Charge Code |
901694627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Adventist Health Commercial |
$4.25
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.10
|
| Rate for Payer: Multiplan Commercial |
$16.99
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
|
|
HC SUTURE CHROMIC CT-2 100063
|
Facility
|
OP
|
$21.24
|
|
| Hospital Charge Code |
901694627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$18.05 |
| Rate for Payer: Adventist Health Commercial |
$4.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.04
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Cigna of CA HMO |
$13.59
|
| Rate for Payer: Cigna of CA PPO |
$15.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.87
|
| Rate for Payer: Multiplan Commercial |
$16.99
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.62
|
| Rate for Payer: United Healthcare All Other HMO |
$10.62
|
| Rate for Payer: United Healthcare HMO Rider |
$10.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.05
|
| Rate for Payer: Vantage Medical Group Senior |
$18.05
|
|
|
HC SUTURE CHROMIC GUT 0 102839
|
Facility
|
OP
|
$29.36
|
|
| Hospital Charge Code |
901694631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$24.96 |
| Rate for Payer: Adventist Health Commercial |
$5.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.03
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Cigna of CA HMO |
$18.79
|
| Rate for Payer: Cigna of CA PPO |
$21.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Senior |
$11.74
|
| Rate for Payer: Galaxy Health WC |
$24.96
|
| Rate for Payer: Global Benefits Group Commercial |
$17.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.55
|
| Rate for Payer: Multiplan Commercial |
$23.49
|
| Rate for Payer: Networks By Design Commercial |
$19.08
|
| Rate for Payer: Prime Health Services Commercial |
$24.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.68
|
| Rate for Payer: United Healthcare All Other HMO |
$14.68
|
| Rate for Payer: United Healthcare HMO Rider |
$14.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.96
|
| Rate for Payer: Vantage Medical Group Senior |
$24.96
|
|
|
HC SUTURE CHROMIC GUT 0 102839
|
Facility
|
IP
|
$29.36
|
|
| Hospital Charge Code |
901694631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$24.96 |
| Rate for Payer: Adventist Health Commercial |
$5.87
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Senior |
$11.74
|
| Rate for Payer: Galaxy Health WC |
$24.96
|
| Rate for Payer: Global Benefits Group Commercial |
$17.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.05
|
| Rate for Payer: Multiplan Commercial |
$23.49
|
| Rate for Payer: Networks By Design Commercial |
$19.08
|
| Rate for Payer: Prime Health Services Commercial |
$24.96
|
|
|
HC SUTURE CHROMIC GUT 0 113342
|
Facility
|
IP
|
$26.97
|
|
| Hospital Charge Code |
901694612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$22.92 |
| Rate for Payer: Adventist Health Commercial |
$5.39
|
| Rate for Payer: Cash Price |
$12.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.79
|
| Rate for Payer: EPIC Health Plan Senior |
$10.79
|
| Rate for Payer: Galaxy Health WC |
$22.92
|
| Rate for Payer: Global Benefits Group Commercial |
$16.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.47
|
| Rate for Payer: Multiplan Commercial |
$21.58
|
| Rate for Payer: Networks By Design Commercial |
$17.53
|
| Rate for Payer: Prime Health Services Commercial |
$22.92
|
|
|
HC SUTURE CHROMIC GUT 0 113342
|
Facility
|
OP
|
$26.97
|
|
| Hospital Charge Code |
901694612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$22.92 |
| Rate for Payer: Adventist Health Commercial |
$5.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.56
|
| Rate for Payer: Cash Price |
$12.14
|
| Rate for Payer: Cigna of CA HMO |
$17.26
|
| Rate for Payer: Cigna of CA PPO |
$19.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.79
|
| Rate for Payer: EPIC Health Plan Senior |
$10.79
|
| Rate for Payer: Galaxy Health WC |
$22.92
|
| Rate for Payer: Global Benefits Group Commercial |
$16.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.88
|
| Rate for Payer: Multiplan Commercial |
$21.58
|
| Rate for Payer: Networks By Design Commercial |
$17.53
|
| Rate for Payer: Prime Health Services Commercial |
$22.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.48
|
| Rate for Payer: United Healthcare All Other HMO |
$13.48
|
| Rate for Payer: United Healthcare HMO Rider |
$13.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.92
|
| Rate for Payer: Vantage Medical Group Senior |
$22.92
|
|
|
HC SUTURE CHROMIC GUT 0 18"210353
|
Facility
|
IP
|
$179.06
|
|
| Hospital Charge Code |
901693102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$152.20 |
| Rate for Payer: Adventist Health Commercial |
$35.81
|
| Rate for Payer: Cash Price |
$80.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.62
|
| Rate for Payer: EPIC Health Plan Senior |
$71.62
|
| Rate for Payer: Galaxy Health WC |
$152.20
|
| Rate for Payer: Global Benefits Group Commercial |
$107.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$110.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.97
|
| Rate for Payer: Multiplan Commercial |
$143.25
|
| Rate for Payer: Networks By Design Commercial |
$116.39
|
| Rate for Payer: Prime Health Services Commercial |
$152.20
|
|
|
HC SUTURE CHROMIC GUT 0 18"210353
|
Facility
|
OP
|
$179.06
|
|
| Hospital Charge Code |
901693102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$152.20 |
| Rate for Payer: Adventist Health Commercial |
$35.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$117.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$152.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$98.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$109.96
|
| Rate for Payer: Cash Price |
$80.58
|
| Rate for Payer: Cigna of CA HMO |
$114.60
|
| Rate for Payer: Cigna of CA PPO |
$132.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$152.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$152.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$152.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.62
|
| Rate for Payer: EPIC Health Plan Senior |
$71.62
|
| Rate for Payer: Galaxy Health WC |
$152.20
|
| Rate for Payer: Global Benefits Group Commercial |
$107.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$110.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$42.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$125.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$125.34
|
| Rate for Payer: Multiplan Commercial |
$143.25
|
| Rate for Payer: Networks By Design Commercial |
$116.39
|
| Rate for Payer: Prime Health Services Commercial |
$152.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$89.53
|
| Rate for Payer: United Healthcare All Other HMO |
$89.53
|
| Rate for Payer: United Healthcare HMO Rider |
$89.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$89.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$152.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$152.20
|
| Rate for Payer: Vantage Medical Group Senior |
$152.20
|
|
|
HC SUTURE CHROMIC GUT 1-0 105493
|
Facility
|
OP
|
$32.55
|
|
| Hospital Charge Code |
901694864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$27.67 |
| Rate for Payer: Adventist Health Commercial |
$6.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.99
|
| Rate for Payer: Cash Price |
$14.65
|
| Rate for Payer: Cigna of CA HMO |
$20.83
|
| Rate for Payer: Cigna of CA PPO |
$24.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.02
|
| Rate for Payer: EPIC Health Plan Senior |
$13.02
|
| Rate for Payer: Galaxy Health WC |
$27.67
|
| Rate for Payer: Global Benefits Group Commercial |
$19.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.79
|
| Rate for Payer: Multiplan Commercial |
$26.04
|
| Rate for Payer: Networks By Design Commercial |
$21.16
|
| Rate for Payer: Prime Health Services Commercial |
$27.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.27
|
| Rate for Payer: United Healthcare All Other HMO |
$16.27
|
| Rate for Payer: United Healthcare HMO Rider |
$16.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.67
|
| Rate for Payer: Vantage Medical Group Senior |
$27.67
|
|
|
HC SUTURE CHROMIC GUT 1-0 105493
|
Facility
|
IP
|
$32.55
|
|
| Hospital Charge Code |
901694864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$27.67 |
| Rate for Payer: Adventist Health Commercial |
$6.51
|
| Rate for Payer: Cash Price |
$14.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.02
|
| Rate for Payer: EPIC Health Plan Senior |
$13.02
|
| Rate for Payer: Galaxy Health WC |
$27.67
|
| Rate for Payer: Global Benefits Group Commercial |
$19.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.81
|
| Rate for Payer: Multiplan Commercial |
$26.04
|
| Rate for Payer: Networks By Design Commercial |
$21.16
|
| Rate for Payer: Prime Health Services Commercial |
$27.67
|
|
|
HC SUTURE CHROMIC GUT 1-0 105628
|
Facility
|
OP
|
$182.42
|
|
| Hospital Charge Code |
901694865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.48 |
| Max. Negotiated Rate |
$155.06 |
| Rate for Payer: Adventist Health Commercial |
$36.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$119.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$155.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$100.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$136.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$112.02
|
| Rate for Payer: Cash Price |
$82.09
|
| Rate for Payer: Cigna of CA HMO |
$116.75
|
| Rate for Payer: Cigna of CA PPO |
$134.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$155.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$155.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$155.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.97
|
| Rate for Payer: EPIC Health Plan Senior |
$72.97
|
| Rate for Payer: Galaxy Health WC |
$155.06
|
| Rate for Payer: Global Benefits Group Commercial |
$109.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$121.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$112.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$127.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$127.69
|
| Rate for Payer: Multiplan Commercial |
$145.94
|
| Rate for Payer: Networks By Design Commercial |
$118.57
|
| Rate for Payer: Prime Health Services Commercial |
$155.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$109.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$109.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.21
|
| Rate for Payer: United Healthcare All Other HMO |
$91.21
|
| Rate for Payer: United Healthcare HMO Rider |
$91.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$155.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$155.06
|
| Rate for Payer: Vantage Medical Group Senior |
$155.06
|
|
|
HC SUTURE CHROMIC GUT 1-0 105628
|
Facility
|
IP
|
$182.42
|
|
| Hospital Charge Code |
901694865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.48 |
| Max. Negotiated Rate |
$155.06 |
| Rate for Payer: Adventist Health Commercial |
$36.48
|
| Rate for Payer: Cash Price |
$82.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.97
|
| Rate for Payer: EPIC Health Plan Senior |
$72.97
|
| Rate for Payer: Galaxy Health WC |
$155.06
|
| Rate for Payer: Global Benefits Group Commercial |
$109.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$121.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$69.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$112.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.78
|
| Rate for Payer: Multiplan Commercial |
$145.94
|
| Rate for Payer: Networks By Design Commercial |
$118.57
|
| Rate for Payer: Prime Health Services Commercial |
$155.06
|
|
|
HC SUTURE CHROMIC GUT 2-0 G5-21
|
Facility
|
IP
|
$61.17
|
|
| Hospital Charge Code |
901698694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$51.99 |
| Rate for Payer: Adventist Health Commercial |
$12.23
|
| Rate for Payer: Cash Price |
$27.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.47
|
| Rate for Payer: EPIC Health Plan Senior |
$24.47
|
| Rate for Payer: Galaxy Health WC |
$51.99
|
| Rate for Payer: Global Benefits Group Commercial |
$36.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.68
|
| Rate for Payer: Multiplan Commercial |
$48.94
|
| Rate for Payer: Networks By Design Commercial |
$39.76
|
| Rate for Payer: Prime Health Services Commercial |
$51.99
|
|
|
HC SUTURE CHROMIC GUT 2-0 G5-21
|
Facility
|
OP
|
$61.17
|
|
| Hospital Charge Code |
901698694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$51.99 |
| Rate for Payer: Adventist Health Commercial |
$12.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.56
|
| Rate for Payer: Cash Price |
$27.53
|
| Rate for Payer: Cigna of CA HMO |
$39.15
|
| Rate for Payer: Cigna of CA PPO |
$45.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.47
|
| Rate for Payer: EPIC Health Plan Senior |
$24.47
|
| Rate for Payer: Galaxy Health WC |
$51.99
|
| Rate for Payer: Global Benefits Group Commercial |
$36.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.82
|
| Rate for Payer: Multiplan Commercial |
$48.94
|
| Rate for Payer: Networks By Design Commercial |
$39.76
|
| Rate for Payer: Prime Health Services Commercial |
$51.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.59
|
| Rate for Payer: United Healthcare All Other HMO |
$30.59
|
| Rate for Payer: United Healthcare HMO Rider |
$30.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.99
|
| Rate for Payer: Vantage Medical Group Senior |
$51.99
|
|
|
HC SUTURE CHROMIC GUT 3-0 7" MH
|
Facility
|
OP
|
$15.17
|
|
| Hospital Charge Code |
901693103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$12.89 |
| Rate for Payer: Adventist Health Commercial |
$3.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.32
|
| Rate for Payer: Cash Price |
$6.83
|
| Rate for Payer: Cigna of CA HMO |
$9.71
|
| Rate for Payer: Cigna of CA PPO |
$11.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Senior |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$12.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.62
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.62
|
| Rate for Payer: Multiplan Commercial |
$12.14
|
| Rate for Payer: Networks By Design Commercial |
$9.86
|
| Rate for Payer: Prime Health Services Commercial |
$12.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.58
|
| Rate for Payer: United Healthcare All Other HMO |
$7.58
|
| Rate for Payer: United Healthcare HMO Rider |
$7.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.89
|
| Rate for Payer: Vantage Medical Group Senior |
$12.89
|
|
|
HC SUTURE CHROMIC GUT 3-0 7" MH
|
Facility
|
IP
|
$15.17
|
|
| Hospital Charge Code |
901693103
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.03 |
| Max. Negotiated Rate |
$12.89 |
| Rate for Payer: Adventist Health Commercial |
$3.03
|
| Rate for Payer: Cash Price |
$6.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.07
|
| Rate for Payer: EPIC Health Plan Senior |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$12.89
|
| Rate for Payer: Global Benefits Group Commercial |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.78
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.64
|
| Rate for Payer: Multiplan Commercial |
$12.14
|
| Rate for Payer: Networks By Design Commercial |
$9.86
|
| Rate for Payer: Prime Health Services Commercial |
$12.89
|
|
|
HC SUTURE CHROMIC GUT 4-0
|
Facility
|
OP
|
$32.88
|
|
| Hospital Charge Code |
901603479
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Adventist Health Commercial |
$6.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.19
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Cigna of CA HMO |
$21.04
|
| Rate for Payer: Cigna of CA PPO |
$24.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.15
|
| Rate for Payer: EPIC Health Plan Senior |
$13.15
|
| Rate for Payer: Galaxy Health WC |
$27.95
|
| Rate for Payer: Global Benefits Group Commercial |
$19.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.02
|
| Rate for Payer: Multiplan Commercial |
$26.30
|
| Rate for Payer: Networks By Design Commercial |
$21.37
|
| Rate for Payer: Prime Health Services Commercial |
$27.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.44
|
| Rate for Payer: United Healthcare All Other HMO |
$16.44
|
| Rate for Payer: United Healthcare HMO Rider |
$16.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.95
|
| Rate for Payer: Vantage Medical Group Senior |
$27.95
|
|
|
HC SUTURE CHROMIC GUT 4-0
|
Facility
|
IP
|
$32.88
|
|
| Hospital Charge Code |
901603479
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$27.95 |
| Rate for Payer: Adventist Health Commercial |
$6.58
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.15
|
| Rate for Payer: EPIC Health Plan Senior |
$13.15
|
| Rate for Payer: Galaxy Health WC |
$27.95
|
| Rate for Payer: Global Benefits Group Commercial |
$19.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.89
|
| Rate for Payer: Multiplan Commercial |
$26.30
|
| Rate for Payer: Networks By Design Commercial |
$21.37
|
| Rate for Payer: Prime Health Services Commercial |
$27.95
|
|
|
HC SUTURE CHROMIC GUT 4-0 27"
|
Facility
|
IP
|
$29.93
|
|
| Hospital Charge Code |
901601293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$25.44 |
| Rate for Payer: Adventist Health Commercial |
$5.99
|
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: EPIC Health Plan Senior |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.18
|
| Rate for Payer: Multiplan Commercial |
$23.94
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
|
|
HC SUTURE CHROMIC GUT 4-0 27"
|
Facility
|
OP
|
$29.93
|
|
| Hospital Charge Code |
901601293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$25.44 |
| Rate for Payer: Adventist Health Commercial |
$5.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.38
|
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Cigna of CA HMO |
$19.16
|
| Rate for Payer: Cigna of CA PPO |
$22.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: EPIC Health Plan Senior |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.95
|
| Rate for Payer: Multiplan Commercial |
$23.94
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.96
|
| Rate for Payer: United Healthcare All Other HMO |
$14.96
|
| Rate for Payer: United Healthcare HMO Rider |
$14.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.44
|
| Rate for Payer: Vantage Medical Group Senior |
$25.44
|
|
