|
HC SUTURE PERMA-HAND 3-0 18" FS-1
|
Facility
|
IP
|
$12.38
|
|
| Hospital Charge Code |
901698192
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$10.52 |
| Rate for Payer: Adventist Health Commercial |
$2.48
|
| Rate for Payer: Cash Price |
$6.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.95
|
| Rate for Payer: EPIC Health Plan Senior |
$4.95
|
| Rate for Payer: Galaxy Health WC |
$10.52
|
| Rate for Payer: Global Benefits Group Commercial |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
| Rate for Payer: Multiplan Commercial |
$9.90
|
| Rate for Payer: Networks By Design Commercial |
$8.05
|
| Rate for Payer: Prime Health Services Commercial |
$10.52
|
|
|
HC SUTURE PERMA-HAND 3-0 18" FS-1
|
Facility
|
OP
|
$12.38
|
|
| Hospital Charge Code |
901698192
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$10.52 |
| Rate for Payer: Adventist Health Commercial |
$2.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.60
|
| Rate for Payer: Cash Price |
$6.81
|
| Rate for Payer: Cigna of CA HMO |
$7.92
|
| Rate for Payer: Cigna of CA PPO |
$9.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.95
|
| Rate for Payer: EPIC Health Plan Senior |
$4.95
|
| Rate for Payer: Galaxy Health WC |
$10.52
|
| Rate for Payer: Global Benefits Group Commercial |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$9.90
|
| Rate for Payer: Networks By Design Commercial |
$8.05
|
| Rate for Payer: Prime Health Services Commercial |
$10.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.19
|
| Rate for Payer: United Healthcare All Other HMO |
$6.19
|
| Rate for Payer: United Healthcare HMO Rider |
$6.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.52
|
| Rate for Payer: Vantage Medical Group Senior |
$10.52
|
|
|
HC SUTURE PLAIN 0 54" LIGA TIES
|
Facility
|
IP
|
$37.15
|
|
| Hospital Charge Code |
901694609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.43 |
| Max. Negotiated Rate |
$31.58 |
| Rate for Payer: Adventist Health Commercial |
$7.43
|
| Rate for Payer: Cash Price |
$20.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.86
|
| Rate for Payer: EPIC Health Plan Senior |
$14.86
|
| Rate for Payer: Galaxy Health WC |
$31.58
|
| Rate for Payer: Global Benefits Group Commercial |
$22.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.92
|
| Rate for Payer: Multiplan Commercial |
$29.72
|
| Rate for Payer: Networks By Design Commercial |
$24.15
|
| Rate for Payer: Prime Health Services Commercial |
$31.58
|
|
|
HC SUTURE PLAIN 0 54" LIGA TIES
|
Facility
|
OP
|
$37.15
|
|
| Hospital Charge Code |
901694609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.43 |
| Max. Negotiated Rate |
$31.58 |
| Rate for Payer: Adventist Health Commercial |
$7.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.81
|
| Rate for Payer: Cash Price |
$20.43
|
| Rate for Payer: Cigna of CA HMO |
$23.78
|
| Rate for Payer: Cigna of CA PPO |
$27.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.86
|
| Rate for Payer: EPIC Health Plan Senior |
$14.86
|
| Rate for Payer: Galaxy Health WC |
$31.58
|
| Rate for Payer: Global Benefits Group Commercial |
$22.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.00
|
| Rate for Payer: Multiplan Commercial |
$29.72
|
| Rate for Payer: Networks By Design Commercial |
$24.15
|
| Rate for Payer: Prime Health Services Commercial |
$31.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.57
|
| Rate for Payer: United Healthcare All Other HMO |
$18.57
|
| Rate for Payer: United Healthcare HMO Rider |
$18.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.58
|
| Rate for Payer: Vantage Medical Group Senior |
$31.58
|
|
|
HC SUTURE PLAIN 3-0 102832
|
Facility
|
IP
|
$35.26
|
|
| Hospital Charge Code |
901694611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$29.97 |
| Rate for Payer: Adventist Health Commercial |
$7.05
|
| Rate for Payer: Cash Price |
$19.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.10
|
| Rate for Payer: EPIC Health Plan Senior |
$14.10
|
| Rate for Payer: Galaxy Health WC |
$29.97
|
| Rate for Payer: Global Benefits Group Commercial |
$21.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.46
|
| Rate for Payer: Multiplan Commercial |
$28.21
|
| Rate for Payer: Networks By Design Commercial |
$22.92
|
| Rate for Payer: Prime Health Services Commercial |
$29.97
|
|
|
HC SUTURE PLAIN 3-0 102832
|
Facility
|
OP
|
$35.26
|
|
| Hospital Charge Code |
901694611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$29.97 |
| Rate for Payer: Adventist Health Commercial |
$7.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.65
|
| Rate for Payer: Cash Price |
$19.39
|
| Rate for Payer: Cigna of CA HMO |
$22.57
|
| Rate for Payer: Cigna of CA PPO |
$26.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.10
|
| Rate for Payer: EPIC Health Plan Senior |
$14.10
|
| Rate for Payer: Galaxy Health WC |
$29.97
|
| Rate for Payer: Global Benefits Group Commercial |
$21.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.68
|
| Rate for Payer: Multiplan Commercial |
$28.21
|
| Rate for Payer: Networks By Design Commercial |
$22.92
|
| Rate for Payer: Prime Health Services Commercial |
$29.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.63
|
| Rate for Payer: United Healthcare All Other HMO |
$17.63
|
| Rate for Payer: United Healthcare HMO Rider |
$17.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.97
|
| Rate for Payer: Vantage Medical Group Senior |
$29.97
|
|
|
HC SUTURE PLAIN 3-0 27" T-29
|
Facility
|
IP
|
$37.97
|
|
| Hospital Charge Code |
901694613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.59 |
| Max. Negotiated Rate |
$32.27 |
| Rate for Payer: Adventist Health Commercial |
$7.59
|
| Rate for Payer: Cash Price |
$20.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.19
|
| Rate for Payer: EPIC Health Plan Senior |
$15.19
|
| Rate for Payer: Galaxy Health WC |
$32.27
|
| Rate for Payer: Global Benefits Group Commercial |
$22.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.11
|
| Rate for Payer: Multiplan Commercial |
$30.38
|
| Rate for Payer: Networks By Design Commercial |
$24.68
|
| Rate for Payer: Prime Health Services Commercial |
$32.27
|
|
|
HC SUTURE PLAIN 3-0 27" T-29
|
Facility
|
OP
|
$37.97
|
|
| Hospital Charge Code |
901694613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.59 |
| Max. Negotiated Rate |
$32.27 |
| Rate for Payer: Adventist Health Commercial |
$7.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.32
|
| Rate for Payer: Cash Price |
$20.88
|
| Rate for Payer: Cigna of CA HMO |
$24.30
|
| Rate for Payer: Cigna of CA PPO |
$28.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.19
|
| Rate for Payer: EPIC Health Plan Senior |
$15.19
|
| Rate for Payer: Galaxy Health WC |
$32.27
|
| Rate for Payer: Global Benefits Group Commercial |
$22.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.58
|
| Rate for Payer: Multiplan Commercial |
$30.38
|
| Rate for Payer: Networks By Design Commercial |
$24.68
|
| Rate for Payer: Prime Health Services Commercial |
$32.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.98
|
| Rate for Payer: United Healthcare All Other HMO |
$18.98
|
| Rate for Payer: United Healthcare HMO Rider |
$18.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.27
|
| Rate for Payer: Vantage Medical Group Senior |
$32.27
|
|
|
HC SUTURE PLAIN 6-0 G-1 101036
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901692002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$53.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$50.36
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC SUTURE PLAIN 6-0 G-1 101036
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901692002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$69.70 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$45.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.24
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$50.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.68
|
| Rate for Payer: Multiplan Commercial |
$65.60
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC SUTURE PLAIN GC3-0 CI1 102834
|
Facility
|
OP
|
$29.27
|
|
| Hospital Charge Code |
901694632
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$24.88 |
| Rate for Payer: Adventist Health Commercial |
$5.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.97
|
| Rate for Payer: Cash Price |
$16.10
|
| Rate for Payer: Cigna of CA HMO |
$18.73
|
| Rate for Payer: Cigna of CA PPO |
$21.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.71
|
| Rate for Payer: EPIC Health Plan Senior |
$11.71
|
| Rate for Payer: Galaxy Health WC |
$24.88
|
| Rate for Payer: Global Benefits Group Commercial |
$17.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.49
|
| Rate for Payer: Multiplan Commercial |
$23.42
|
| Rate for Payer: Networks By Design Commercial |
$19.03
|
| Rate for Payer: Prime Health Services Commercial |
$24.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.63
|
| Rate for Payer: United Healthcare All Other HMO |
$14.63
|
| Rate for Payer: United Healthcare HMO Rider |
$14.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.88
|
| Rate for Payer: Vantage Medical Group Senior |
$24.88
|
|
|
HC SUTURE PLAIN GC3-0 CI1 102834
|
Facility
|
IP
|
$29.27
|
|
| Hospital Charge Code |
901694632
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$24.88 |
| Rate for Payer: Adventist Health Commercial |
$5.85
|
| Rate for Payer: Cash Price |
$16.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.71
|
| Rate for Payer: EPIC Health Plan Senior |
$11.71
|
| Rate for Payer: Galaxy Health WC |
$24.88
|
| Rate for Payer: Global Benefits Group Commercial |
$17.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.02
|
| Rate for Payer: Multiplan Commercial |
$23.42
|
| Rate for Payer: Networks By Design Commercial |
$19.03
|
| Rate for Payer: Prime Health Services Commercial |
$24.88
|
|
|
HC SUTURE PLAIN GUT 4-0 P-3
|
Facility
|
OP
|
$38.62
|
|
| Hospital Charge Code |
901694889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.72
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.03
|
| Rate for Payer: Multiplan Commercial |
$30.90
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
|
HC SUTURE PLAIN GUT 4-0 P-3
|
Facility
|
IP
|
$38.62
|
|
| Hospital Charge Code |
901694889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$32.83 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Cash Price |
$21.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.27
|
| Rate for Payer: Multiplan Commercial |
$30.90
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
|
HC SUTURE PLAIN GUT 5-0 18 10044
|
Facility
|
IP
|
$66.99
|
|
| Hospital Charge Code |
901694886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$56.94 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Cash Price |
$36.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.80
|
| Rate for Payer: EPIC Health Plan Senior |
$26.80
|
| Rate for Payer: Galaxy Health WC |
$56.94
|
| Rate for Payer: Global Benefits Group Commercial |
$40.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.08
|
| Rate for Payer: Multiplan Commercial |
$53.59
|
| Rate for Payer: Networks By Design Commercial |
$43.54
|
| Rate for Payer: Prime Health Services Commercial |
$56.94
|
|
|
HC SUTURE PLAIN GUT 5-0 18 10044
|
Facility
|
OP
|
$66.99
|
|
| Hospital Charge Code |
901694886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$56.94 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$50.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.14
|
| Rate for Payer: Cash Price |
$36.84
|
| Rate for Payer: Cigna of CA HMO |
$42.87
|
| Rate for Payer: Cigna of CA PPO |
$49.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.80
|
| Rate for Payer: EPIC Health Plan Senior |
$26.80
|
| Rate for Payer: Galaxy Health WC |
$56.94
|
| Rate for Payer: Global Benefits Group Commercial |
$40.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.89
|
| Rate for Payer: Multiplan Commercial |
$53.59
|
| Rate for Payer: Networks By Design Commercial |
$43.54
|
| Rate for Payer: Prime Health Services Commercial |
$56.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.49
|
| Rate for Payer: United Healthcare All Other HMO |
$33.49
|
| Rate for Payer: United Healthcare HMO Rider |
$33.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.94
|
| Rate for Payer: Vantage Medical Group Senior |
$56.94
|
|
|
HC SUTURE PLAIN GUT 5-0 18" P-2
|
Facility
|
IP
|
$65.60
|
|
| Hospital Charge Code |
901601963
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$55.76 |
| Rate for Payer: Adventist Health Commercial |
$13.12
|
| Rate for Payer: Cash Price |
$36.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.24
|
| Rate for Payer: EPIC Health Plan Senior |
$26.24
|
| Rate for Payer: Galaxy Health WC |
$55.76
|
| Rate for Payer: Global Benefits Group Commercial |
$39.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.74
|
| Rate for Payer: Multiplan Commercial |
$52.48
|
| Rate for Payer: Networks By Design Commercial |
$42.64
|
| Rate for Payer: Prime Health Services Commercial |
$55.76
|
|
|
HC SUTURE PLAIN GUT 5-0 18" P-2
|
Facility
|
OP
|
$65.60
|
|
| Hospital Charge Code |
901601963
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$55.76 |
| Rate for Payer: Adventist Health Commercial |
$13.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.28
|
| Rate for Payer: Cash Price |
$36.08
|
| Rate for Payer: Cigna of CA HMO |
$41.98
|
| Rate for Payer: Cigna of CA PPO |
$48.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.24
|
| Rate for Payer: EPIC Health Plan Senior |
$26.24
|
| Rate for Payer: Galaxy Health WC |
$55.76
|
| Rate for Payer: Global Benefits Group Commercial |
$39.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.92
|
| Rate for Payer: Multiplan Commercial |
$52.48
|
| Rate for Payer: Networks By Design Commercial |
$42.64
|
| Rate for Payer: Prime Health Services Commercial |
$55.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.80
|
| Rate for Payer: United Healthcare All Other HMO |
$32.80
|
| Rate for Payer: United Healthcare HMO Rider |
$32.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.76
|
| Rate for Payer: Vantage Medical Group Senior |
$55.76
|
|
|
HC SUTURE PLAIN GUT 6-0 18" PC1
|
Facility
|
IP
|
$48.46
|
|
| Hospital Charge Code |
901601964
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$41.19 |
| Rate for Payer: Adventist Health Commercial |
$9.69
|
| Rate for Payer: Cash Price |
$26.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.38
|
| Rate for Payer: EPIC Health Plan Senior |
$19.38
|
| Rate for Payer: Galaxy Health WC |
$41.19
|
| Rate for Payer: Global Benefits Group Commercial |
$29.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.63
|
| Rate for Payer: Multiplan Commercial |
$38.77
|
| Rate for Payer: Networks By Design Commercial |
$31.50
|
| Rate for Payer: Prime Health Services Commercial |
$41.19
|
|
|
HC SUTURE PLAIN GUT 6-0 18" PC1
|
Facility
|
OP
|
$48.46
|
|
| Hospital Charge Code |
901601964
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$41.19 |
| Rate for Payer: Adventist Health Commercial |
$9.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.76
|
| Rate for Payer: Cash Price |
$26.65
|
| Rate for Payer: Cigna of CA HMO |
$31.01
|
| Rate for Payer: Cigna of CA PPO |
$35.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.38
|
| Rate for Payer: EPIC Health Plan Senior |
$19.38
|
| Rate for Payer: Galaxy Health WC |
$41.19
|
| Rate for Payer: Global Benefits Group Commercial |
$29.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.92
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.92
|
| Rate for Payer: Multiplan Commercial |
$38.77
|
| Rate for Payer: Networks By Design Commercial |
$31.50
|
| Rate for Payer: Prime Health Services Commercial |
$41.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.23
|
| Rate for Payer: United Healthcare All Other HMO |
$24.23
|
| Rate for Payer: United Healthcare HMO Rider |
$24.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.19
|
| Rate for Payer: Vantage Medical Group Senior |
$41.19
|
|
|
HC SUTURE PLAIN TIES 2-0 102840
|
Facility
|
IP
|
$247.59
|
|
| Hospital Charge Code |
901694610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.52 |
| Max. Negotiated Rate |
$210.45 |
| Rate for Payer: Adventist Health Commercial |
$49.52
|
| Rate for Payer: Cash Price |
$136.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.04
|
| Rate for Payer: EPIC Health Plan Senior |
$99.04
|
| Rate for Payer: Galaxy Health WC |
$210.45
|
| Rate for Payer: Global Benefits Group Commercial |
$148.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$153.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.42
|
| Rate for Payer: Multiplan Commercial |
$198.07
|
| Rate for Payer: Networks By Design Commercial |
$160.93
|
| Rate for Payer: Prime Health Services Commercial |
$210.45
|
|
|
HC SUTURE PLAIN TIES 2-0 102840
|
Facility
|
OP
|
$247.59
|
|
| Hospital Charge Code |
901694610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.52 |
| Max. Negotiated Rate |
$210.45 |
| Rate for Payer: Adventist Health Commercial |
$49.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$162.39
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$210.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$185.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152.05
|
| Rate for Payer: Cash Price |
$136.17
|
| Rate for Payer: Cigna of CA HMO |
$158.46
|
| Rate for Payer: Cigna of CA PPO |
$183.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$210.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$210.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$210.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.04
|
| Rate for Payer: EPIC Health Plan Senior |
$99.04
|
| Rate for Payer: Galaxy Health WC |
$210.45
|
| Rate for Payer: Global Benefits Group Commercial |
$148.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$165.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$94.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$153.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$59.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$173.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$173.31
|
| Rate for Payer: Multiplan Commercial |
$198.07
|
| Rate for Payer: Networks By Design Commercial |
$160.93
|
| Rate for Payer: Prime Health Services Commercial |
$210.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$148.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$148.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.80
|
| Rate for Payer: United Healthcare All Other HMO |
$123.80
|
| Rate for Payer: United Healthcare HMO Rider |
$123.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$210.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$210.45
|
| Rate for Payer: Vantage Medical Group Senior |
$210.45
|
|
|
HC SUTURE PROLENE 0 101004
|
Facility
|
IP
|
$16.81
|
|
| Hospital Charge Code |
901693104
|
|
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 |
$9.25
|
| 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 PROLENE 0 101004
|
Facility
|
OP
|
$16.81
|
|
| Hospital Charge Code |
901693104
|
|
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 |
$9.25
|
| 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 PROLENE 0 CT-1 100077
|
Facility
|
OP
|
$25.26
|
|
| Hospital Charge Code |
901693105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.05 |
| Max. Negotiated Rate |
$21.47 |
| Rate for Payer: Adventist Health Commercial |
$5.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.57
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.51
|
| Rate for Payer: Cash Price |
$13.89
|
| Rate for Payer: Cigna of CA HMO |
$16.17
|
| Rate for Payer: Cigna of CA PPO |
$18.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.10
|
| Rate for Payer: EPIC Health Plan Senior |
$10.10
|
| Rate for Payer: Galaxy Health WC |
$21.47
|
| Rate for Payer: Global Benefits Group Commercial |
$15.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.68
|
| Rate for Payer: Multiplan Commercial |
$20.21
|
| Rate for Payer: Networks By Design Commercial |
$16.42
|
| Rate for Payer: Prime Health Services Commercial |
$21.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.63
|
| Rate for Payer: United Healthcare All Other HMO |
$12.63
|
| Rate for Payer: United Healthcare HMO Rider |
$12.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.47
|
| Rate for Payer: Vantage Medical Group Senior |
$21.47
|
|
