|
HC SUTURE PROLENE 5-0 C-1 24" 8725H
|
Facility
|
IP
|
$124.79
|
|
| Hospital Charge Code |
901691017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.96 |
| Max. Negotiated Rate |
$106.07 |
| Rate for Payer: Adventist Health Commercial |
$24.96
|
| Rate for Payer: Cash Price |
$56.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.92
|
| Rate for Payer: EPIC Health Plan Senior |
$49.92
|
| Rate for Payer: Galaxy Health WC |
$106.07
|
| Rate for Payer: Global Benefits Group Commercial |
$74.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$83.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$47.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$77.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$29.95
|
| Rate for Payer: Multiplan Commercial |
$99.83
|
| Rate for Payer: Networks By Design Commercial |
$81.11
|
| Rate for Payer: Prime Health Services Commercial |
$106.07
|
|
|
HC SUTURE PROLENE 5-0 DBL ARM RB
|
Facility
|
IP
|
$57.48
|
|
| Hospital Charge Code |
901603043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$48.86 |
| Rate for Payer: Adventist Health Commercial |
$11.50
|
| Rate for Payer: Cash Price |
$25.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.99
|
| Rate for Payer: EPIC Health Plan Senior |
$22.99
|
| Rate for Payer: Galaxy Health WC |
$48.86
|
| Rate for Payer: Global Benefits Group Commercial |
$34.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.80
|
| Rate for Payer: Multiplan Commercial |
$45.98
|
| Rate for Payer: Networks By Design Commercial |
$37.36
|
| Rate for Payer: Prime Health Services Commercial |
$48.86
|
|
|
HC SUTURE PROLENE 5-0 DBL ARM RB
|
Facility
|
OP
|
$57.48
|
|
| Hospital Charge Code |
901603043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.50 |
| Max. Negotiated Rate |
$48.86 |
| Rate for Payer: Adventist Health Commercial |
$11.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$43.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.30
|
| Rate for Payer: Cash Price |
$25.87
|
| Rate for Payer: Cigna of CA HMO |
$36.79
|
| Rate for Payer: Cigna of CA PPO |
$42.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$48.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.99
|
| Rate for Payer: EPIC Health Plan Senior |
$22.99
|
| Rate for Payer: Galaxy Health WC |
$48.86
|
| Rate for Payer: Global Benefits Group Commercial |
$34.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$38.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$40.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40.24
|
| Rate for Payer: Multiplan Commercial |
$45.98
|
| Rate for Payer: Networks By Design Commercial |
$37.36
|
| Rate for Payer: Prime Health Services Commercial |
$48.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.74
|
| Rate for Payer: United Healthcare All Other HMO |
$28.74
|
| Rate for Payer: United Healthcare HMO Rider |
$28.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$48.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48.86
|
| Rate for Payer: Vantage Medical Group Senior |
$48.86
|
|
|
HC SUTURE PROLENE 5 HS BLUE 1X30"
|
Facility
|
OP
|
$139.92
|
|
| Hospital Charge Code |
901698848
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.98 |
| Max. Negotiated Rate |
$118.93 |
| Rate for Payer: Adventist Health Commercial |
$27.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$118.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$76.96
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$104.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.92
|
| Rate for Payer: Cash Price |
$62.96
|
| Rate for Payer: Cigna of CA HMO |
$89.55
|
| Rate for Payer: Cigna of CA PPO |
$103.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$118.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$118.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$118.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.97
|
| Rate for Payer: EPIC Health Plan Senior |
$55.97
|
| Rate for Payer: Galaxy Health WC |
$118.93
|
| Rate for Payer: Global Benefits Group Commercial |
$83.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$97.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$97.94
|
| Rate for Payer: Multiplan Commercial |
$111.94
|
| Rate for Payer: Networks By Design Commercial |
$90.95
|
| Rate for Payer: Prime Health Services Commercial |
$118.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$83.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$83.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.96
|
| Rate for Payer: United Healthcare All Other HMO |
$69.96
|
| Rate for Payer: United Healthcare HMO Rider |
$69.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$118.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$118.93
|
| Rate for Payer: Vantage Medical Group Senior |
$118.93
|
|
|
HC SUTURE PROLENE 5 HS BLUE 1X30"
|
Facility
|
IP
|
$139.92
|
|
| Hospital Charge Code |
901698848
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$27.98 |
| Max. Negotiated Rate |
$118.93 |
| Rate for Payer: Adventist Health Commercial |
$27.98
|
| Rate for Payer: Cash Price |
$62.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.97
|
| Rate for Payer: EPIC Health Plan Senior |
$55.97
|
| Rate for Payer: Galaxy Health WC |
$118.93
|
| Rate for Payer: Global Benefits Group Commercial |
$83.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.58
|
| Rate for Payer: Multiplan Commercial |
$111.94
|
| Rate for Payer: Networks By Design Commercial |
$90.95
|
| Rate for Payer: Prime Health Services Commercial |
$118.93
|
|
|
HC SUTURE PROLENE 6-0 18"
|
Facility
|
OP
|
$65.44
|
|
| Hospital Charge Code |
901603486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$55.62 |
| Rate for Payer: Adventist Health Commercial |
$13.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$42.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.19
|
| Rate for Payer: Cash Price |
$29.45
|
| Rate for Payer: Cigna of CA HMO |
$41.88
|
| Rate for Payer: Cigna of CA PPO |
$48.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.18
|
| Rate for Payer: EPIC Health Plan Senior |
$26.18
|
| Rate for Payer: Galaxy Health WC |
$55.62
|
| Rate for Payer: Global Benefits Group Commercial |
$39.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$45.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$45.81
|
| Rate for Payer: Multiplan Commercial |
$52.35
|
| Rate for Payer: Networks By Design Commercial |
$42.54
|
| Rate for Payer: Prime Health Services Commercial |
$55.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.72
|
| Rate for Payer: United Healthcare All Other HMO |
$32.72
|
| Rate for Payer: United Healthcare HMO Rider |
$32.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.62
|
| Rate for Payer: Vantage Medical Group Senior |
$55.62
|
|
|
HC SUTURE PROLENE 6-0 18"
|
Facility
|
IP
|
$65.44
|
|
| Hospital Charge Code |
901603486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$55.62 |
| Rate for Payer: Adventist Health Commercial |
$13.09
|
| Rate for Payer: Cash Price |
$29.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.18
|
| Rate for Payer: EPIC Health Plan Senior |
$26.18
|
| Rate for Payer: Galaxy Health WC |
$55.62
|
| Rate for Payer: Global Benefits Group Commercial |
$39.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$43.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.71
|
| Rate for Payer: Multiplan Commercial |
$52.35
|
| Rate for Payer: Networks By Design Commercial |
$42.54
|
| Rate for Payer: Prime Health Services Commercial |
$55.62
|
|
|
HC SUTURE PROLENE 6-0 18" P-3
|
Facility
|
OP
|
$60.02
|
|
| Hospital Charge Code |
901601975
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$51.02 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.86
|
| Rate for Payer: Cash Price |
$27.01
|
| Rate for Payer: Cigna of CA HMO |
$38.41
|
| Rate for Payer: Cigna of CA PPO |
$44.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.01
|
| Rate for Payer: EPIC Health Plan Senior |
$24.01
|
| Rate for Payer: Galaxy Health WC |
$51.02
|
| Rate for Payer: Global Benefits Group Commercial |
$36.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.01
|
| Rate for Payer: Multiplan Commercial |
$48.02
|
| Rate for Payer: Networks By Design Commercial |
$39.01
|
| Rate for Payer: Prime Health Services Commercial |
$51.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.01
|
| Rate for Payer: United Healthcare All Other HMO |
$30.01
|
| Rate for Payer: United Healthcare HMO Rider |
$30.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.02
|
| Rate for Payer: Vantage Medical Group Senior |
$51.02
|
|
|
HC SUTURE PROLENE 6-0 18" P-3
|
Facility
|
IP
|
$60.02
|
|
| Hospital Charge Code |
901601975
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$51.02 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$27.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.01
|
| Rate for Payer: EPIC Health Plan Senior |
$24.01
|
| Rate for Payer: Galaxy Health WC |
$51.02
|
| Rate for Payer: Global Benefits Group Commercial |
$36.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.40
|
| Rate for Payer: Multiplan Commercial |
$48.02
|
| Rate for Payer: Networks By Design Commercial |
$39.01
|
| Rate for Payer: Prime Health Services Commercial |
$51.02
|
|
|
HC SUTURE PROLENE 6-0 DBL ARM RB
|
Facility
|
OP
|
$41.98
|
|
| Hospital Charge Code |
901603044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$35.68 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.78
|
| Rate for Payer: Cash Price |
$18.89
|
| Rate for Payer: Cigna of CA HMO |
$26.87
|
| Rate for Payer: Cigna of CA PPO |
$31.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$35.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.79
|
| Rate for Payer: EPIC Health Plan Senior |
$16.79
|
| Rate for Payer: Galaxy Health WC |
$35.68
|
| Rate for Payer: Global Benefits Group Commercial |
$25.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.39
|
| Rate for Payer: Multiplan Commercial |
$33.58
|
| Rate for Payer: Networks By Design Commercial |
$27.29
|
| Rate for Payer: Prime Health Services Commercial |
$35.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.99
|
| Rate for Payer: United Healthcare All Other HMO |
$20.99
|
| Rate for Payer: United Healthcare HMO Rider |
$20.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$35.68
|
| Rate for Payer: Vantage Medical Group Senior |
$35.68
|
|
|
HC SUTURE PROLENE 6-0 DBL ARM RB
|
Facility
|
IP
|
$41.98
|
|
| Hospital Charge Code |
901603044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$35.68 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Cash Price |
$18.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.79
|
| Rate for Payer: EPIC Health Plan Senior |
$16.79
|
| Rate for Payer: Galaxy Health WC |
$35.68
|
| Rate for Payer: Global Benefits Group Commercial |
$25.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.08
|
| Rate for Payer: Multiplan Commercial |
$33.58
|
| Rate for Payer: Networks By Design Commercial |
$27.29
|
| Rate for Payer: Prime Health Services Commercial |
$35.68
|
|
|
HC SUTURE PROLENE 7-0 24" BV-1
|
Facility
|
IP
|
$118.18
|
|
| Hospital Charge Code |
901604393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$100.45 |
| Rate for Payer: Adventist Health Commercial |
$23.64
|
| Rate for Payer: Cash Price |
$53.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.27
|
| Rate for Payer: EPIC Health Plan Senior |
$47.27
|
| Rate for Payer: Galaxy Health WC |
$100.45
|
| Rate for Payer: Global Benefits Group Commercial |
$70.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.36
|
| Rate for Payer: Multiplan Commercial |
$94.54
|
| Rate for Payer: Networks By Design Commercial |
$76.82
|
| Rate for Payer: Prime Health Services Commercial |
$100.45
|
|
|
HC SUTURE PROLENE 7-0 24" BV-1
|
Facility
|
OP
|
$118.18
|
|
| Hospital Charge Code |
901604393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$100.45 |
| Rate for Payer: Adventist Health Commercial |
$23.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$77.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$65.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$88.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$72.57
|
| Rate for Payer: Cash Price |
$53.18
|
| Rate for Payer: Cigna of CA HMO |
$75.64
|
| Rate for Payer: Cigna of CA PPO |
$87.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$100.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$100.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.27
|
| Rate for Payer: EPIC Health Plan Senior |
$47.27
|
| Rate for Payer: Galaxy Health WC |
$100.45
|
| Rate for Payer: Global Benefits Group Commercial |
$70.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$78.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$73.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$82.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$82.73
|
| Rate for Payer: Multiplan Commercial |
$94.54
|
| Rate for Payer: Networks By Design Commercial |
$76.82
|
| Rate for Payer: Prime Health Services Commercial |
$100.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$59.09
|
| Rate for Payer: United Healthcare All Other HMO |
$59.09
|
| Rate for Payer: United Healthcare HMO Rider |
$59.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$100.45
|
| Rate for Payer: Vantage Medical Group Senior |
$100.45
|
|
|
HC SUTURE SILK 0 18"
|
Facility
|
IP
|
$24.76
|
|
| Hospital Charge Code |
901603230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$21.05 |
| Rate for Payer: Adventist Health Commercial |
$4.95
|
| Rate for Payer: Cash Price |
$11.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.90
|
| Rate for Payer: EPIC Health Plan Senior |
$9.90
|
| Rate for Payer: Galaxy Health WC |
$21.05
|
| Rate for Payer: Global Benefits Group Commercial |
$14.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.94
|
| Rate for Payer: Multiplan Commercial |
$19.81
|
| Rate for Payer: Networks By Design Commercial |
$16.09
|
| Rate for Payer: Prime Health Services Commercial |
$21.05
|
|
|
HC SUTURE SILK 0 18"
|
Facility
|
OP
|
$24.76
|
|
| Hospital Charge Code |
901603230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$21.05 |
| Rate for Payer: Adventist Health Commercial |
$4.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.21
|
| Rate for Payer: Cash Price |
$11.14
|
| Rate for Payer: Cigna of CA HMO |
$15.85
|
| Rate for Payer: Cigna of CA PPO |
$18.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.90
|
| Rate for Payer: EPIC Health Plan Senior |
$9.90
|
| Rate for Payer: Galaxy Health WC |
$21.05
|
| Rate for Payer: Global Benefits Group Commercial |
$14.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.33
|
| Rate for Payer: Multiplan Commercial |
$19.81
|
| Rate for Payer: Networks By Design Commercial |
$16.09
|
| Rate for Payer: Prime Health Services Commercial |
$21.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.38
|
| Rate for Payer: United Healthcare All Other HMO |
$12.38
|
| Rate for Payer: United Healthcare HMO Rider |
$12.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.05
|
| Rate for Payer: Vantage Medical Group Senior |
$21.05
|
|
|
HC SUTURE SILK 0 18" 678H
|
Facility
|
IP
|
$12.87
|
|
| Hospital Charge Code |
901601275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$10.94 |
| Rate for Payer: Adventist Health Commercial |
$2.57
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: EPIC Health Plan Senior |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.09
|
| Rate for Payer: Multiplan Commercial |
$10.30
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
|
|
HC SUTURE SILK 0 18" 678H
|
Facility
|
OP
|
$12.87
|
|
| Hospital Charge Code |
901601275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$10.94 |
| Rate for Payer: Adventist Health Commercial |
$2.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.90
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Cigna of CA HMO |
$8.24
|
| Rate for Payer: Cigna of CA PPO |
$9.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: EPIC Health Plan Senior |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.01
|
| Rate for Payer: Multiplan Commercial |
$10.30
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.43
|
| Rate for Payer: United Healthcare All Other HMO |
$6.43
|
| Rate for Payer: United Healthcare HMO Rider |
$6.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.94
|
| Rate for Payer: Vantage Medical Group Senior |
$10.94
|
|
|
HC SUTURE SILK 0 18" BR 119068
|
Facility
|
IP
|
$13.94
|
|
| Hospital Charge Code |
901691006
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$11.85 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Cash Price |
$6.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.35
|
| Rate for Payer: Multiplan Commercial |
$11.15
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
|
|
HC SUTURE SILK 0 18" BR 119068
|
Facility
|
OP
|
$13.94
|
|
| Hospital Charge Code |
901691006
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$11.85 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.56
|
| Rate for Payer: Cash Price |
$6.27
|
| Rate for Payer: Cigna of CA HMO |
$8.92
|
| Rate for Payer: Cigna of CA PPO |
$10.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.76
|
| Rate for Payer: Multiplan Commercial |
$11.15
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.97
|
| Rate for Payer: United Healthcare All Other HMO |
$6.97
|
| Rate for Payer: United Healthcare HMO Rider |
$6.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.85
|
| Rate for Payer: Vantage Medical Group Senior |
$11.85
|
|
|
HC SUTURE SILK 0 30" 680H
|
Facility
|
IP
|
$18.04
|
|
| Hospital Charge Code |
901604311
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$15.33 |
| Rate for Payer: Adventist Health Commercial |
$3.61
|
| Rate for Payer: Cash Price |
$8.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.22
|
| Rate for Payer: EPIC Health Plan Senior |
$7.22
|
| Rate for Payer: Galaxy Health WC |
$15.33
|
| Rate for Payer: Global Benefits Group Commercial |
$10.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.33
|
| Rate for Payer: Multiplan Commercial |
$14.43
|
| Rate for Payer: Networks By Design Commercial |
$11.73
|
| Rate for Payer: Prime Health Services Commercial |
$15.33
|
|
|
HC SUTURE SILK 0 30" 680H
|
Facility
|
OP
|
$18.04
|
|
| Hospital Charge Code |
901604311
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$15.33 |
| Rate for Payer: Adventist Health Commercial |
$3.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.08
|
| Rate for Payer: Cash Price |
$8.12
|
| Rate for Payer: Cigna of CA HMO |
$11.55
|
| Rate for Payer: Cigna of CA PPO |
$13.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.22
|
| Rate for Payer: EPIC Health Plan Senior |
$7.22
|
| Rate for Payer: Galaxy Health WC |
$15.33
|
| Rate for Payer: Global Benefits Group Commercial |
$10.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.63
|
| Rate for Payer: Multiplan Commercial |
$14.43
|
| Rate for Payer: Networks By Design Commercial |
$11.73
|
| Rate for Payer: Prime Health Services Commercial |
$15.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.02
|
| Rate for Payer: United Healthcare All Other HMO |
$9.02
|
| Rate for Payer: United Healthcare HMO Rider |
$9.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.33
|
| Rate for Payer: Vantage Medical Group Senior |
$15.33
|
|
|
HC SUTURE SILK 2-0 18" FS
|
Facility
|
OP
|
$17.06
|
|
| Hospital Charge Code |
901601276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$14.50 |
| Rate for Payer: Adventist Health Commercial |
$3.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.48
|
| Rate for Payer: Cash Price |
$7.68
|
| Rate for Payer: Cigna of CA HMO |
$10.92
|
| Rate for Payer: Cigna of CA PPO |
$12.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.82
|
| Rate for Payer: EPIC Health Plan Senior |
$6.82
|
| Rate for Payer: Galaxy Health WC |
$14.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.94
|
| Rate for Payer: Multiplan Commercial |
$13.65
|
| Rate for Payer: Networks By Design Commercial |
$11.09
|
| Rate for Payer: Prime Health Services Commercial |
$14.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.53
|
| Rate for Payer: United Healthcare All Other HMO |
$8.53
|
| Rate for Payer: United Healthcare HMO Rider |
$8.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.50
|
| Rate for Payer: Vantage Medical Group Senior |
$14.50
|
|
|
HC SUTURE SILK 2-0 18" FS
|
Facility
|
IP
|
$17.06
|
|
| Hospital Charge Code |
901601276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$14.50 |
| Rate for Payer: Adventist Health Commercial |
$3.41
|
| Rate for Payer: Cash Price |
$7.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.82
|
| Rate for Payer: EPIC Health Plan Senior |
$6.82
|
| Rate for Payer: Galaxy Health WC |
$14.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.09
|
| Rate for Payer: Multiplan Commercial |
$13.65
|
| Rate for Payer: Networks By Design Commercial |
$11.09
|
| Rate for Payer: Prime Health Services Commercial |
$14.50
|
|
|
HC SUTURE SILK 2-0 24" 100301
|
Facility
|
OP
|
$25.75
|
|
| Hospital Charge Code |
901694654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$21.89 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.81
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Cigna of CA HMO |
$16.48
|
| Rate for Payer: Cigna of CA PPO |
$19.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.02
|
| Rate for Payer: Multiplan Commercial |
$20.60
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO |
$12.88
|
| Rate for Payer: United Healthcare HMO Rider |
$12.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.89
|
| Rate for Payer: Vantage Medical Group Senior |
$21.89
|
|
|
HC SUTURE SILK 2-0 24" 100301
|
Facility
|
IP
|
$25.75
|
|
| Hospital Charge Code |
901694654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$21.89 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.18
|
| Rate for Payer: Multiplan Commercial |
$20.60
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
|
