|
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 |
$7.53
|
| 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
|
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 |
$11.00
|
| 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 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 |
$11.00
|
| 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 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 |
$8.41
|
| 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 |
$8.41
|
| 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
|
|
|
HC SUTURE VICRYL 0 27"
|
Facility
|
IP
|
$14.30
|
|
| Hospital Charge Code |
901693116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$12.15 |
| Rate for Payer: Adventist Health Commercial |
$2.86
|
| Rate for Payer: Cash Price |
$6.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.72
|
| Rate for Payer: EPIC Health Plan Senior |
$5.72
|
| Rate for Payer: Galaxy Health WC |
$12.15
|
| Rate for Payer: Global Benefits Group Commercial |
$8.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.43
|
| Rate for Payer: Multiplan Commercial |
$11.44
|
| Rate for Payer: Networks By Design Commercial |
$9.29
|
| Rate for Payer: Prime Health Services Commercial |
$12.15
|
|
|
HC SUTURE VICRYL 0 27"
|
Facility
|
OP
|
$14.30
|
|
| Hospital Charge Code |
901693116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$12.15 |
| Rate for Payer: Adventist Health Commercial |
$2.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.78
|
| Rate for Payer: Cash Price |
$6.44
|
| Rate for Payer: Cigna of CA HMO |
$9.15
|
| Rate for Payer: Cigna of CA PPO |
$10.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.72
|
| Rate for Payer: EPIC Health Plan Senior |
$5.72
|
| Rate for Payer: Galaxy Health WC |
$12.15
|
| Rate for Payer: Global Benefits Group Commercial |
$8.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.01
|
| Rate for Payer: Multiplan Commercial |
$11.44
|
| Rate for Payer: Networks By Design Commercial |
$9.29
|
| Rate for Payer: Prime Health Services Commercial |
$12.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.15
|
| Rate for Payer: United Healthcare All Other HMO |
$7.15
|
| Rate for Payer: United Healthcare HMO Rider |
$7.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.15
|
| Rate for Payer: Vantage Medical Group Senior |
$12.15
|
|
|
HC SUTURE VICRYL 0 27" 101315
|
Facility
|
OP
|
$16.24
|
|
| Hospital Charge Code |
901694619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.97
|
| Rate for Payer: Cash Price |
$7.31
|
| Rate for Payer: Cigna of CA HMO |
$10.39
|
| Rate for Payer: Cigna of CA PPO |
$12.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.50
|
| Rate for Payer: EPIC Health Plan Senior |
$6.50
|
| Rate for Payer: Galaxy Health WC |
$13.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.37
|
| Rate for Payer: Multiplan Commercial |
$12.99
|
| Rate for Payer: Networks By Design Commercial |
$10.56
|
| Rate for Payer: Prime Health Services Commercial |
$13.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.12
|
| Rate for Payer: United Healthcare All Other HMO |
$8.12
|
| Rate for Payer: United Healthcare HMO Rider |
$8.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.80
|
| Rate for Payer: Vantage Medical Group Senior |
$13.80
|
|
|
HC SUTURE VICRYL 0 27" 101315
|
Facility
|
IP
|
$16.24
|
|
| Hospital Charge Code |
901694619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.25 |
| Max. Negotiated Rate |
$13.80 |
| Rate for Payer: Adventist Health Commercial |
$3.25
|
| Rate for Payer: Cash Price |
$7.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.50
|
| Rate for Payer: EPIC Health Plan Senior |
$6.50
|
| Rate for Payer: Galaxy Health WC |
$13.80
|
| Rate for Payer: Global Benefits Group Commercial |
$9.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.90
|
| Rate for Payer: Multiplan Commercial |
$12.99
|
| Rate for Payer: Networks By Design Commercial |
$10.56
|
| Rate for Payer: Prime Health Services Commercial |
$13.80
|
|
|
HC SUTURE VICRYL 0 54"BR 100304
|
Facility
|
IP
|
$21.48
|
|
| Hospital Charge Code |
901694608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$18.26 |
| Rate for Payer: Adventist Health Commercial |
$4.30
|
| Rate for Payer: Cash Price |
$9.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.59
|
| Rate for Payer: EPIC Health Plan Senior |
$8.59
|
| Rate for Payer: Galaxy Health WC |
$18.26
|
| Rate for Payer: Global Benefits Group Commercial |
$12.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.16
|
| Rate for Payer: Multiplan Commercial |
$17.18
|
| Rate for Payer: Networks By Design Commercial |
$13.96
|
| Rate for Payer: Prime Health Services Commercial |
$18.26
|
|
|
HC SUTURE VICRYL 0 54"BR 100304
|
Facility
|
OP
|
$21.48
|
|
| Hospital Charge Code |
901694608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.30 |
| Max. Negotiated Rate |
$18.26 |
| Rate for Payer: Adventist Health Commercial |
$4.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.19
|
| Rate for Payer: Cash Price |
$9.67
|
| Rate for Payer: Cigna of CA HMO |
$13.75
|
| Rate for Payer: Cigna of CA PPO |
$15.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.59
|
| Rate for Payer: EPIC Health Plan Senior |
$8.59
|
| Rate for Payer: Galaxy Health WC |
$18.26
|
| Rate for Payer: Global Benefits Group Commercial |
$12.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.04
|
| Rate for Payer: Multiplan Commercial |
$17.18
|
| Rate for Payer: Networks By Design Commercial |
$13.96
|
| Rate for Payer: Prime Health Services Commercial |
$18.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.74
|
| Rate for Payer: United Healthcare All Other HMO |
$10.74
|
| Rate for Payer: United Healthcare HMO Rider |
$10.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.26
|
| Rate for Payer: Vantage Medical Group Senior |
$18.26
|
|
|
HC SUTURE VICRYL 0 CR 104520
|
Facility
|
IP
|
$17.71
|
|
| Hospital Charge Code |
901693127
|
|
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 |
$7.97
|
| 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 VICRYL 0 CR 104520
|
Facility
|
OP
|
$17.71
|
|
| Hospital Charge Code |
901693127
|
|
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 |
$7.97
|
| 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 VICRYL 0 CT-2 103660
|
Facility
|
IP
|
$16.73
|
|
| Hospital Charge Code |
901694872
|
|
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 |
$7.53
|
| 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 VICRYL 0 CT-2 103660
|
Facility
|
OP
|
$16.73
|
|
| Hospital Charge Code |
901694872
|
|
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 |
$7.53
|
| 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 VICRYL 1-0 102831
|
Facility
|
IP
|
$15.74
|
|
| Hospital Charge Code |
901694618
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$13.38 |
| Rate for Payer: Adventist Health Commercial |
$3.15
|
| Rate for Payer: Cash Price |
$7.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.30
|
| Rate for Payer: EPIC Health Plan Senior |
$6.30
|
| Rate for Payer: Galaxy Health WC |
$13.38
|
| Rate for Payer: Global Benefits Group Commercial |
$9.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.78
|
| Rate for Payer: Multiplan Commercial |
$12.59
|
| Rate for Payer: Networks By Design Commercial |
$10.23
|
| Rate for Payer: Prime Health Services Commercial |
$13.38
|
|
|
HC SUTURE VICRYL 1-0 102831
|
Facility
|
OP
|
$15.74
|
|
| Hospital Charge Code |
901694618
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.15 |
| Max. Negotiated Rate |
$13.38 |
| Rate for Payer: Adventist Health Commercial |
$3.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.67
|
| Rate for Payer: Cash Price |
$7.08
|
| Rate for Payer: Cigna of CA HMO |
$10.07
|
| Rate for Payer: Cigna of CA PPO |
$11.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.38
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.30
|
| Rate for Payer: EPIC Health Plan Senior |
$6.30
|
| Rate for Payer: Galaxy Health WC |
$13.38
|
| Rate for Payer: Global Benefits Group Commercial |
$9.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.00
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.02
|
| Rate for Payer: Multiplan Commercial |
$12.59
|
| Rate for Payer: Networks By Design Commercial |
$10.23
|
| Rate for Payer: Prime Health Services Commercial |
$13.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.87
|
| Rate for Payer: United Healthcare All Other HMO |
$7.87
|
| Rate for Payer: United Healthcare HMO Rider |
$7.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.38
|
| Rate for Payer: Vantage Medical Group Senior |
$13.38
|
|
|
HC SUTURE VICRYL 1-0 218854
|
Facility
|
OP
|
$13.36
|
|
| Hospital Charge Code |
901693125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$11.36 |
| Rate for Payer: Adventist Health Commercial |
$2.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.20
|
| Rate for Payer: Cash Price |
$6.01
|
| Rate for Payer: Cigna of CA HMO |
$8.55
|
| Rate for Payer: Cigna of CA PPO |
$9.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.34
|
| Rate for Payer: EPIC Health Plan Senior |
$5.34
|
| Rate for Payer: Galaxy Health WC |
$11.36
|
| Rate for Payer: Global Benefits Group Commercial |
$8.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.35
|
| Rate for Payer: Multiplan Commercial |
$10.69
|
| Rate for Payer: Networks By Design Commercial |
$8.68
|
| Rate for Payer: Prime Health Services Commercial |
$11.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.68
|
| Rate for Payer: United Healthcare All Other HMO |
$6.68
|
| Rate for Payer: United Healthcare HMO Rider |
$6.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.36
|
| Rate for Payer: Vantage Medical Group Senior |
$11.36
|
|
|
HC SUTURE VICRYL 1-0 218854
|
Facility
|
IP
|
$13.36
|
|
| Hospital Charge Code |
901693125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$11.36 |
| Rate for Payer: Adventist Health Commercial |
$2.67
|
| Rate for Payer: Cash Price |
$6.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.34
|
| Rate for Payer: EPIC Health Plan Senior |
$5.34
|
| Rate for Payer: Galaxy Health WC |
$11.36
|
| Rate for Payer: Global Benefits Group Commercial |
$8.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.21
|
| Rate for Payer: Multiplan Commercial |
$10.69
|
| Rate for Payer: Networks By Design Commercial |
$8.68
|
| Rate for Payer: Prime Health Services Commercial |
$11.36
|
|
|
HC SUTURE VICRYL 1-0 27" BR
|
Facility
|
IP
|
$16.65
|
|
| Hospital Charge Code |
901601960
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$14.15 |
| Rate for Payer: Adventist Health Commercial |
$3.33
|
| Rate for Payer: Cash Price |
$7.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.66
|
| Rate for Payer: EPIC Health Plan Senior |
$6.66
|
| Rate for Payer: Galaxy Health WC |
$14.15
|
| Rate for Payer: Global Benefits Group Commercial |
$9.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Multiplan Commercial |
$13.32
|
| Rate for Payer: Networks By Design Commercial |
$10.82
|
| Rate for Payer: Prime Health Services Commercial |
$14.15
|
|
|
HC SUTURE VICRYL 1-0 27" BR
|
Facility
|
OP
|
$16.65
|
|
| Hospital Charge Code |
901601960
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.33 |
| Max. Negotiated Rate |
$14.15 |
| Rate for Payer: Adventist Health Commercial |
$3.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.22
|
| Rate for Payer: Cash Price |
$7.49
|
| Rate for Payer: Cigna of CA HMO |
$10.66
|
| Rate for Payer: Cigna of CA PPO |
$12.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.66
|
| Rate for Payer: EPIC Health Plan Senior |
$6.66
|
| Rate for Payer: Galaxy Health WC |
$14.15
|
| Rate for Payer: Global Benefits Group Commercial |
$9.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.65
|
| Rate for Payer: Multiplan Commercial |
$13.32
|
| Rate for Payer: Networks By Design Commercial |
$10.82
|
| Rate for Payer: Prime Health Services Commercial |
$14.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.32
|
| Rate for Payer: United Healthcare All Other HMO |
$8.32
|
| Rate for Payer: United Healthcare HMO Rider |
$8.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.15
|
| Rate for Payer: Vantage Medical Group Senior |
$14.15
|
|
|
HC SUTURE VICRYL+ 1-0 ANTIBC
|
Facility
|
OP
|
$16.89
|
|
| Hospital Charge Code |
901693108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$14.36 |
| Rate for Payer: Adventist Health Commercial |
$3.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.37
|
| Rate for Payer: Cash Price |
$7.60
|
| Rate for Payer: Cigna of CA HMO |
$10.81
|
| Rate for Payer: Cigna of CA PPO |
$12.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.36
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.76
|
| Rate for Payer: EPIC Health Plan Senior |
$6.76
|
| Rate for Payer: Galaxy Health WC |
$14.36
|
| Rate for Payer: Global Benefits Group Commercial |
$10.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.82
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.82
|
| Rate for Payer: Multiplan Commercial |
$13.51
|
| Rate for Payer: Networks By Design Commercial |
$10.98
|
| Rate for Payer: Prime Health Services Commercial |
$14.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.45
|
| Rate for Payer: United Healthcare All Other HMO |
$8.45
|
| Rate for Payer: United Healthcare HMO Rider |
$8.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$14.36
|
|
|
HC SUTURE VICRYL+ 1-0 ANTIBC
|
Facility
|
IP
|
$16.89
|
|
| Hospital Charge Code |
901693108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$14.36 |
| Rate for Payer: Adventist Health Commercial |
$3.38
|
| Rate for Payer: Cash Price |
$7.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.76
|
| Rate for Payer: EPIC Health Plan Senior |
$6.76
|
| Rate for Payer: Galaxy Health WC |
$14.36
|
| Rate for Payer: Global Benefits Group Commercial |
$10.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.05
|
| Rate for Payer: Multiplan Commercial |
$13.51
|
| Rate for Payer: Networks By Design Commercial |
$10.98
|
| Rate for Payer: Prime Health Services Commercial |
$14.36
|
|
|
HC SUTURE VICRYL 1-0 CT BR100074
|
Facility
|
IP
|
$16.81
|
|
| Hospital Charge Code |
901694877
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$14.29 |
| Rate for Payer: Adventist Health Commercial |
$3.36
|
| Rate for Payer: Cash Price |
$7.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.72
|
| Rate for Payer: EPIC Health Plan Senior |
$6.72
|
| Rate for Payer: Galaxy Health WC |
$14.29
|
| Rate for Payer: Global Benefits Group Commercial |
$10.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.03
|
| Rate for Payer: Multiplan Commercial |
$13.45
|
| Rate for Payer: Networks By Design Commercial |
$10.93
|
| Rate for Payer: Prime Health Services Commercial |
$14.29
|
|
|
HC SUTURE VICRYL 1-0 CT BR100074
|
Facility
|
OP
|
$16.81
|
|
| Hospital Charge Code |
901694877
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$14.29 |
| Rate for Payer: Adventist Health Commercial |
$3.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.32
|
| Rate for Payer: Cash Price |
$7.56
|
| Rate for Payer: Cigna of CA HMO |
$10.76
|
| Rate for Payer: Cigna of CA PPO |
$12.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.72
|
| Rate for Payer: EPIC Health Plan Senior |
$6.72
|
| Rate for Payer: Galaxy Health WC |
$14.29
|
| Rate for Payer: Global Benefits Group Commercial |
$10.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.77
|
| Rate for Payer: Multiplan Commercial |
$13.45
|
| Rate for Payer: Networks By Design Commercial |
$10.93
|
| Rate for Payer: Prime Health Services Commercial |
$14.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.40
|
| Rate for Payer: United Healthcare All Other HMO |
$8.40
|
| Rate for Payer: United Healthcare HMO Rider |
$8.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.29
|
| Rate for Payer: Vantage Medical Group Senior |
$14.29
|
|
