|
HC SUTURE SILK 2-0 FS 100123
|
Facility
|
OP
|
$11.56
|
|
| Hospital Charge Code |
901694658
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$9.83 |
| Rate for Payer: Adventist Health Commercial |
$2.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.10
|
| Rate for Payer: Cash Price |
$6.36
|
| Rate for Payer: Cigna of CA HMO |
$7.40
|
| Rate for Payer: Cigna of CA PPO |
$8.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.62
|
| Rate for Payer: EPIC Health Plan Senior |
$4.62
|
| Rate for Payer: Galaxy Health WC |
$9.83
|
| Rate for Payer: Global Benefits Group Commercial |
$6.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.09
|
| Rate for Payer: Multiplan Commercial |
$9.25
|
| Rate for Payer: Networks By Design Commercial |
$7.51
|
| Rate for Payer: Prime Health Services Commercial |
$9.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.78
|
| Rate for Payer: United Healthcare All Other HMO |
$5.78
|
| Rate for Payer: United Healthcare HMO Rider |
$5.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.83
|
| Rate for Payer: Vantage Medical Group Senior |
$9.83
|
|
|
HC SUTURE SILK #2, 60" 116183
|
Facility
|
IP
|
$13.94
|
|
| Hospital Charge Code |
901694661
|
|
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 |
$7.67
|
| 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 #2, 60" 116183
|
Facility
|
OP
|
$13.94
|
|
| Hospital Charge Code |
901694661
|
|
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 |
$7.67
|
| 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 3-0 108252
|
Facility
|
OP
|
$13.53
|
|
| Hospital Charge Code |
901694657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$11.50 |
| Rate for Payer: Adventist Health Commercial |
$2.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.31
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: Cigna of CA HMO |
$8.66
|
| Rate for Payer: Cigna of CA PPO |
$10.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.41
|
| Rate for Payer: EPIC Health Plan Senior |
$5.41
|
| Rate for Payer: Galaxy Health WC |
$11.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.47
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.47
|
| Rate for Payer: Multiplan Commercial |
$10.82
|
| Rate for Payer: Networks By Design Commercial |
$8.79
|
| Rate for Payer: Prime Health Services Commercial |
$11.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.76
|
| Rate for Payer: United Healthcare All Other HMO |
$6.76
|
| Rate for Payer: United Healthcare HMO Rider |
$6.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.50
|
| Rate for Payer: Vantage Medical Group Senior |
$11.50
|
|
|
HC SUTURE SILK 3-0 108252
|
Facility
|
IP
|
$13.53
|
|
| Hospital Charge Code |
901694657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$11.50 |
| Rate for Payer: Adventist Health Commercial |
$2.71
|
| Rate for Payer: Cash Price |
$7.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.41
|
| Rate for Payer: EPIC Health Plan Senior |
$5.41
|
| Rate for Payer: Galaxy Health WC |
$11.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.25
|
| Rate for Payer: Multiplan Commercial |
$10.82
|
| Rate for Payer: Networks By Design Commercial |
$8.79
|
| Rate for Payer: Prime Health Services Commercial |
$11.50
|
|
|
HC SUTURE SILK 3-0 18" FS-1
|
Facility
|
OP
|
$17.71
|
|
| Hospital Charge Code |
901604018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$15.05 |
| Rate for Payer: Adventist Health Commercial |
$3.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.88
|
| Rate for Payer: Cash Price |
$9.74
|
| Rate for Payer: Cigna of CA HMO |
$11.33
|
| Rate for Payer: Cigna of CA PPO |
$13.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.08
|
| Rate for Payer: EPIC Health Plan Senior |
$7.08
|
| Rate for Payer: Galaxy Health WC |
$15.05
|
| Rate for Payer: Global Benefits Group Commercial |
$10.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.40
|
| Rate for Payer: Multiplan Commercial |
$14.17
|
| Rate for Payer: Networks By Design Commercial |
$11.51
|
| Rate for Payer: Prime Health Services Commercial |
$15.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.86
|
| Rate for Payer: United Healthcare All Other HMO |
$8.86
|
| Rate for Payer: United Healthcare HMO Rider |
$8.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
HC SUTURE SILK 3-0 18" FS-1
|
Facility
|
IP
|
$17.71
|
|
| Hospital Charge Code |
901604018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$15.05 |
| Rate for Payer: Adventist Health Commercial |
$3.54
|
| Rate for Payer: Cash Price |
$9.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.08
|
| Rate for Payer: EPIC Health Plan Senior |
$7.08
|
| Rate for Payer: Galaxy Health WC |
$15.05
|
| Rate for Payer: Global Benefits Group Commercial |
$10.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Multiplan Commercial |
$14.17
|
| Rate for Payer: Networks By Design Commercial |
$11.51
|
| Rate for Payer: Prime Health Services Commercial |
$15.05
|
|
|
HC SUTURE SILK 3-0 18" PS-2
|
Facility
|
IP
|
$35.59
|
|
| Hospital Charge Code |
901604404
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$30.25 |
| Rate for Payer: Adventist Health Commercial |
$7.12
|
| Rate for Payer: Cash Price |
$19.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.24
|
| Rate for Payer: EPIC Health Plan Senior |
$14.24
|
| Rate for Payer: Galaxy Health WC |
$30.25
|
| Rate for Payer: Global Benefits Group Commercial |
$21.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.54
|
| Rate for Payer: Multiplan Commercial |
$28.47
|
| Rate for Payer: Networks By Design Commercial |
$23.13
|
| Rate for Payer: Prime Health Services Commercial |
$30.25
|
|
|
HC SUTURE SILK 3-0 18" PS-2
|
Facility
|
OP
|
$35.59
|
|
| Hospital Charge Code |
901604404
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$30.25 |
| Rate for Payer: Adventist Health Commercial |
$7.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.86
|
| Rate for Payer: Cash Price |
$19.57
|
| Rate for Payer: Cigna of CA HMO |
$22.78
|
| Rate for Payer: Cigna of CA PPO |
$26.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.24
|
| Rate for Payer: EPIC Health Plan Senior |
$14.24
|
| Rate for Payer: Galaxy Health WC |
$30.25
|
| Rate for Payer: Global Benefits Group Commercial |
$21.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.91
|
| Rate for Payer: Multiplan Commercial |
$28.47
|
| Rate for Payer: Networks By Design Commercial |
$23.13
|
| Rate for Payer: Prime Health Services Commercial |
$30.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.80
|
| Rate for Payer: United Healthcare All Other HMO |
$17.80
|
| Rate for Payer: United Healthcare HMO Rider |
$17.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.25
|
| Rate for Payer: Vantage Medical Group Senior |
$30.25
|
|
|
HC SUTURE SILK 3-0 24"
|
Facility
|
IP
|
$25.75
|
|
| Hospital Charge Code |
901601278
|
|
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 |
$14.16
|
| 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
|
|
|
HC SUTURE SILK 3-0 24"
|
Facility
|
OP
|
$25.75
|
|
| Hospital Charge Code |
901601278
|
|
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 |
$14.16
|
| 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 3-0 30" BRD
|
Facility
|
IP
|
$12.05
|
|
| Hospital Charge Code |
901693130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$10.24 |
| Rate for Payer: Adventist Health Commercial |
$2.41
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Senior |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: Multiplan Commercial |
$9.64
|
| Rate for Payer: Networks By Design Commercial |
$7.83
|
| Rate for Payer: Prime Health Services Commercial |
$10.24
|
|
|
HC SUTURE SILK 3-0 30" BRD
|
Facility
|
OP
|
$12.05
|
|
| Hospital Charge Code |
901693130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$10.24 |
| Rate for Payer: Adventist Health Commercial |
$2.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.40
|
| Rate for Payer: Cash Price |
$6.63
|
| Rate for Payer: Cigna of CA HMO |
$7.71
|
| Rate for Payer: Cigna of CA PPO |
$8.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Senior |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.44
|
| Rate for Payer: Multiplan Commercial |
$9.64
|
| Rate for Payer: Networks By Design Commercial |
$7.83
|
| Rate for Payer: Prime Health Services Commercial |
$10.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.03
|
| Rate for Payer: United Healthcare All Other HMO |
$6.03
|
| Rate for Payer: United Healthcare HMO Rider |
$6.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.24
|
| Rate for Payer: Vantage Medical Group Senior |
$10.24
|
|
|
HC SUTURE SILK 3-0 BR 299391
|
Facility
|
IP
|
$19.35
|
|
| Hospital Charge Code |
901693132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$16.45 |
| Rate for Payer: Adventist Health Commercial |
$3.87
|
| Rate for Payer: Cash Price |
$10.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.74
|
| Rate for Payer: EPIC Health Plan Senior |
$7.74
|
| Rate for Payer: Galaxy Health WC |
$16.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.64
|
| Rate for Payer: Multiplan Commercial |
$15.48
|
| Rate for Payer: Networks By Design Commercial |
$12.58
|
| Rate for Payer: Prime Health Services Commercial |
$16.45
|
|
|
HC SUTURE SILK 3-0 BR 299391
|
Facility
|
OP
|
$19.35
|
|
| Hospital Charge Code |
901693132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$16.45 |
| Rate for Payer: Adventist Health Commercial |
$3.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.88
|
| Rate for Payer: Cash Price |
$10.64
|
| Rate for Payer: Cigna of CA HMO |
$12.38
|
| Rate for Payer: Cigna of CA PPO |
$14.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.74
|
| Rate for Payer: EPIC Health Plan Senior |
$7.74
|
| Rate for Payer: Galaxy Health WC |
$16.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.54
|
| Rate for Payer: Multiplan Commercial |
$15.48
|
| Rate for Payer: Networks By Design Commercial |
$12.58
|
| Rate for Payer: Prime Health Services Commercial |
$16.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.68
|
| Rate for Payer: United Healthcare All Other HMO |
$9.68
|
| Rate for Payer: United Healthcare HMO Rider |
$9.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.45
|
| Rate for Payer: Vantage Medical Group Senior |
$16.45
|
|
|
HC SUTURE SILK 3-0 CR SA9G
|
Facility
|
IP
|
$12.18
|
|
| Hospital Charge Code |
901693128
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$10.35 |
| Rate for Payer: Adventist Health Commercial |
$2.44
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.87
|
| Rate for Payer: EPIC Health Plan Senior |
$4.87
|
| Rate for Payer: Galaxy Health WC |
$10.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.92
|
| Rate for Payer: Multiplan Commercial |
$9.74
|
| Rate for Payer: Networks By Design Commercial |
$7.92
|
| Rate for Payer: Prime Health Services Commercial |
$10.35
|
|
|
HC SUTURE SILK 3-0 CR SA9G
|
Facility
|
OP
|
$12.18
|
|
| Hospital Charge Code |
901693128
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$10.35 |
| Rate for Payer: Adventist Health Commercial |
$2.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.48
|
| Rate for Payer: Cash Price |
$6.70
|
| Rate for Payer: Cigna of CA HMO |
$7.80
|
| Rate for Payer: Cigna of CA PPO |
$9.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.87
|
| Rate for Payer: EPIC Health Plan Senior |
$4.87
|
| Rate for Payer: Galaxy Health WC |
$10.35
|
| Rate for Payer: Global Benefits Group Commercial |
$7.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.53
|
| Rate for Payer: Multiplan Commercial |
$9.74
|
| Rate for Payer: Networks By Design Commercial |
$7.92
|
| Rate for Payer: Prime Health Services Commercial |
$10.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.09
|
| Rate for Payer: United Healthcare All Other HMO |
$6.09
|
| Rate for Payer: United Healthcare HMO Rider |
$6.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.35
|
| Rate for Payer: Vantage Medical Group Senior |
$10.35
|
|
|
HC SUTURE SILK 4-0 18" C-3
|
Facility
|
OP
|
$19.52
|
|
| Hospital Charge Code |
901604353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Adventist Health Commercial |
$3.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.99
|
| Rate for Payer: Cash Price |
$10.74
|
| Rate for Payer: Cigna of CA HMO |
$12.49
|
| Rate for Payer: Cigna of CA PPO |
$14.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.81
|
| Rate for Payer: EPIC Health Plan Senior |
$7.81
|
| Rate for Payer: Galaxy Health WC |
$16.59
|
| Rate for Payer: Global Benefits Group Commercial |
$11.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.66
|
| Rate for Payer: Multiplan Commercial |
$15.62
|
| Rate for Payer: Networks By Design Commercial |
$12.69
|
| Rate for Payer: Prime Health Services Commercial |
$16.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.76
|
| Rate for Payer: United Healthcare All Other HMO |
$9.76
|
| Rate for Payer: United Healthcare HMO Rider |
$9.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.59
|
| Rate for Payer: Vantage Medical Group Senior |
$16.59
|
|
|
HC SUTURE SILK 4-0 18" C-3
|
Facility
|
IP
|
$19.52
|
|
| Hospital Charge Code |
901604353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.90 |
| Max. Negotiated Rate |
$16.59 |
| Rate for Payer: Adventist Health Commercial |
$3.90
|
| Rate for Payer: Cash Price |
$10.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.81
|
| Rate for Payer: EPIC Health Plan Senior |
$7.81
|
| Rate for Payer: Galaxy Health WC |
$16.59
|
| Rate for Payer: Global Benefits Group Commercial |
$11.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$12.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.68
|
| Rate for Payer: Multiplan Commercial |
$15.62
|
| Rate for Payer: Networks By Design Commercial |
$12.69
|
| Rate for Payer: Prime Health Services Commercial |
$16.59
|
|
|
HC SUTURE SILK 4-0 18" FS-2
|
Facility
|
OP
|
$16.73
|
|
| Hospital Charge Code |
901601280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$14.22 |
| Rate for Payer: Adventist Health Commercial |
$3.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.27
|
| Rate for Payer: Cash Price |
$9.20
|
| Rate for Payer: Cigna of CA HMO |
$10.71
|
| Rate for Payer: Cigna of CA PPO |
$12.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.69
|
| Rate for Payer: EPIC Health Plan Senior |
$6.69
|
| Rate for Payer: Galaxy Health WC |
$14.22
|
| Rate for Payer: Global Benefits Group Commercial |
$10.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.71
|
| Rate for Payer: Multiplan Commercial |
$13.38
|
| Rate for Payer: Networks By Design Commercial |
$10.87
|
| Rate for Payer: Prime Health Services Commercial |
$14.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.37
|
| Rate for Payer: United Healthcare All Other HMO |
$8.37
|
| Rate for Payer: United Healthcare HMO Rider |
$8.37
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.22
|
| Rate for Payer: Vantage Medical Group Senior |
$14.22
|
|
|
HC SUTURE SILK 4-0 18" FS-2
|
Facility
|
IP
|
$16.73
|
|
| Hospital Charge Code |
901601280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$14.22 |
| Rate for Payer: Adventist Health Commercial |
$3.35
|
| Rate for Payer: Cash Price |
$9.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.69
|
| Rate for Payer: EPIC Health Plan Senior |
$6.69
|
| Rate for Payer: Galaxy Health WC |
$14.22
|
| Rate for Payer: Global Benefits Group Commercial |
$10.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.02
|
| Rate for Payer: Multiplan Commercial |
$13.38
|
| Rate for Payer: Networks By Design Commercial |
$10.87
|
| Rate for Payer: Prime Health Services Commercial |
$14.22
|
|
|
HC SUTURE SILK 4-0 24"
|
Facility
|
IP
|
$24.44
|
|
| Hospital Charge Code |
901604349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$20.77 |
| Rate for Payer: Adventist Health Commercial |
$4.89
|
| Rate for Payer: Cash Price |
$13.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.78
|
| Rate for Payer: EPIC Health Plan Senior |
$9.78
|
| Rate for Payer: Galaxy Health WC |
$20.77
|
| Rate for Payer: Global Benefits Group Commercial |
$14.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.87
|
| Rate for Payer: Multiplan Commercial |
$19.55
|
| Rate for Payer: Networks By Design Commercial |
$15.89
|
| Rate for Payer: Prime Health Services Commercial |
$20.77
|
|
|
HC SUTURE SILK 4-0 24"
|
Facility
|
OP
|
$24.44
|
|
| Hospital Charge Code |
901604349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.89 |
| Max. Negotiated Rate |
$20.77 |
| Rate for Payer: Adventist Health Commercial |
$4.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.01
|
| Rate for Payer: Cash Price |
$13.44
|
| Rate for Payer: Cigna of CA HMO |
$15.64
|
| Rate for Payer: Cigna of CA PPO |
$18.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.78
|
| Rate for Payer: EPIC Health Plan Senior |
$9.78
|
| Rate for Payer: Galaxy Health WC |
$20.77
|
| Rate for Payer: Global Benefits Group Commercial |
$14.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.11
|
| Rate for Payer: Multiplan Commercial |
$19.55
|
| Rate for Payer: Networks By Design Commercial |
$15.89
|
| Rate for Payer: Prime Health Services Commercial |
$20.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.22
|
| Rate for Payer: United Healthcare All Other HMO |
$12.22
|
| Rate for Payer: United Healthcare HMO Rider |
$12.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.77
|
| Rate for Payer: Vantage Medical Group Senior |
$20.77
|
|
|
HC SUTURE VICRYL 0 100426
|
Facility
|
IP
|
$18.70
|
|
| Hospital Charge Code |
901693114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Adventist Health Commercial |
$3.74
|
| Rate for Payer: Cash Price |
$10.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.48
|
| Rate for Payer: EPIC Health Plan Senior |
$7.48
|
| Rate for Payer: Galaxy Health WC |
$15.89
|
| Rate for Payer: Global Benefits Group Commercial |
$11.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.49
|
| Rate for Payer: Multiplan Commercial |
$14.96
|
| Rate for Payer: Networks By Design Commercial |
$12.15
|
| Rate for Payer: Prime Health Services Commercial |
$15.89
|
|
|
HC SUTURE VICRYL 0 100426
|
Facility
|
OP
|
$18.70
|
|
| Hospital Charge Code |
901693114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.74 |
| Max. Negotiated Rate |
$15.89 |
| Rate for Payer: Adventist Health Commercial |
$3.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.48
|
| Rate for Payer: Cash Price |
$10.29
|
| Rate for Payer: Cigna of CA HMO |
$11.97
|
| Rate for Payer: Cigna of CA PPO |
$13.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.48
|
| Rate for Payer: EPIC Health Plan Senior |
$7.48
|
| Rate for Payer: Galaxy Health WC |
$15.89
|
| Rate for Payer: Global Benefits Group Commercial |
$11.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.09
|
| Rate for Payer: Multiplan Commercial |
$14.96
|
| Rate for Payer: Networks By Design Commercial |
$12.15
|
| Rate for Payer: Prime Health Services Commercial |
$15.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.35
|
| Rate for Payer: United Healthcare All Other HMO |
$9.35
|
| Rate for Payer: United Healthcare HMO Rider |
$9.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.89
|
| Rate for Payer: Vantage Medical Group Senior |
$15.89
|
|
