|
HC SUTURE VICRYL 3-0 18" UD BRD
|
Facility
|
OP
|
$33.95
|
|
| Hospital Charge Code |
901694946
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$28.86 |
| Rate for Payer: Adventist Health Commercial |
$6.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.85
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Cigna of CA HMO |
$21.73
|
| Rate for Payer: Cigna of CA PPO |
$25.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.58
|
| Rate for Payer: EPIC Health Plan Senior |
$13.58
|
| Rate for Payer: Galaxy Health WC |
$28.86
|
| Rate for Payer: Global Benefits Group Commercial |
$20.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.77
|
| Rate for Payer: Multiplan Commercial |
$27.16
|
| Rate for Payer: Networks By Design Commercial |
$22.07
|
| Rate for Payer: Prime Health Services Commercial |
$28.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.98
|
| Rate for Payer: United Healthcare All Other HMO |
$16.98
|
| Rate for Payer: United Healthcare HMO Rider |
$16.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.86
|
| Rate for Payer: Vantage Medical Group Senior |
$28.86
|
|
|
HC SUTURE VICRYL 3-0 27" CT1
|
Facility
|
IP
|
$16.15
|
|
| Hospital Charge Code |
901602883
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$13.73 |
| Rate for Payer: Adventist Health Commercial |
$3.23
|
| Rate for Payer: Cash Price |
$7.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: EPIC Health Plan Senior |
$6.46
|
| Rate for Payer: Galaxy Health WC |
$13.73
|
| Rate for Payer: Global Benefits Group Commercial |
$9.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.88
|
| Rate for Payer: Multiplan Commercial |
$12.92
|
| Rate for Payer: Networks By Design Commercial |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$13.73
|
|
|
HC SUTURE VICRYL 3-0 27" CT1
|
Facility
|
OP
|
$16.15
|
|
| Hospital Charge Code |
901602883
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$13.73 |
| Rate for Payer: Adventist Health Commercial |
$3.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.92
|
| Rate for Payer: Cash Price |
$7.27
|
| Rate for Payer: Cigna of CA HMO |
$10.34
|
| Rate for Payer: Cigna of CA PPO |
$11.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: EPIC Health Plan Senior |
$6.46
|
| Rate for Payer: Galaxy Health WC |
$13.73
|
| Rate for Payer: Global Benefits Group Commercial |
$9.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.30
|
| Rate for Payer: Multiplan Commercial |
$12.92
|
| Rate for Payer: Networks By Design Commercial |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$13.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.07
|
| Rate for Payer: United Healthcare All Other HMO |
$8.07
|
| Rate for Payer: United Healthcare HMO Rider |
$8.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.73
|
| Rate for Payer: Vantage Medical Group Senior |
$13.73
|
|
|
HC SUTURE VICRYL 3-0 27" RB-1
|
Facility
|
OP
|
$18.04
|
|
| Hospital Charge Code |
901604408
|
|
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 VICRYL 3-0 27" RB-1
|
Facility
|
IP
|
$18.04
|
|
| Hospital Charge Code |
901604408
|
|
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 VICRYL 3-0 27" SH
|
Facility
|
OP
|
$16.07
|
|
| Hospital Charge Code |
901604300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$13.66 |
| Rate for Payer: Adventist Health Commercial |
$3.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.87
|
| Rate for Payer: Cash Price |
$7.23
|
| Rate for Payer: Cigna of CA HMO |
$10.28
|
| Rate for Payer: Cigna of CA PPO |
$11.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.43
|
| Rate for Payer: EPIC Health Plan Senior |
$6.43
|
| Rate for Payer: Galaxy Health WC |
$13.66
|
| Rate for Payer: Global Benefits Group Commercial |
$9.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.25
|
| Rate for Payer: Multiplan Commercial |
$12.86
|
| Rate for Payer: Networks By Design Commercial |
$10.45
|
| Rate for Payer: Prime Health Services Commercial |
$13.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.04
|
| Rate for Payer: United Healthcare All Other HMO |
$8.04
|
| Rate for Payer: United Healthcare HMO Rider |
$8.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.66
|
| Rate for Payer: Vantage Medical Group Senior |
$13.66
|
|
|
HC SUTURE VICRYL 3-0 27" SH
|
Facility
|
IP
|
$16.07
|
|
| Hospital Charge Code |
901604300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.21 |
| Max. Negotiated Rate |
$13.66 |
| Rate for Payer: Adventist Health Commercial |
$3.21
|
| Rate for Payer: Cash Price |
$7.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.43
|
| Rate for Payer: EPIC Health Plan Senior |
$6.43
|
| Rate for Payer: Galaxy Health WC |
$13.66
|
| Rate for Payer: Global Benefits Group Commercial |
$9.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.86
|
| Rate for Payer: Multiplan Commercial |
$12.86
|
| Rate for Payer: Networks By Design Commercial |
$10.45
|
| Rate for Payer: Prime Health Services Commercial |
$13.66
|
|
|
HC SUTURE VICRYL 3-0 REEL 101330
|
Facility
|
IP
|
$13.45
|
|
| Hospital Charge Code |
901694875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$11.43 |
| Rate for Payer: Adventist Health Commercial |
$2.69
|
| Rate for Payer: Cash Price |
$6.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.38
|
| Rate for Payer: EPIC Health Plan Senior |
$5.38
|
| Rate for Payer: Galaxy Health WC |
$11.43
|
| Rate for Payer: Global Benefits Group Commercial |
$8.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.23
|
| Rate for Payer: Multiplan Commercial |
$10.76
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
|
|
HC SUTURE VICRYL 3-0 REEL 101330
|
Facility
|
OP
|
$13.45
|
|
| Hospital Charge Code |
901694875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$11.43 |
| Rate for Payer: Adventist Health Commercial |
$2.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.26
|
| Rate for Payer: Cash Price |
$6.05
|
| Rate for Payer: Cigna of CA HMO |
$8.61
|
| Rate for Payer: Cigna of CA PPO |
$9.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.38
|
| Rate for Payer: EPIC Health Plan Senior |
$5.38
|
| Rate for Payer: Galaxy Health WC |
$11.43
|
| Rate for Payer: Global Benefits Group Commercial |
$8.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.41
|
| Rate for Payer: Multiplan Commercial |
$10.76
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.72
|
| Rate for Payer: United Healthcare All Other HMO |
$6.72
|
| Rate for Payer: United Healthcare HMO Rider |
$6.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.43
|
| Rate for Payer: Vantage Medical Group Senior |
$11.43
|
|
|
HC SUTURE VICRYL 4-0 18" PS-2
|
Facility
|
OP
|
$29.60
|
|
| Hospital Charge Code |
901604233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.92 |
| Max. Negotiated Rate |
$25.16 |
| Rate for Payer: Adventist Health Commercial |
$5.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.18
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: Cigna of CA HMO |
$18.94
|
| Rate for Payer: Cigna of CA PPO |
$21.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.84
|
| Rate for Payer: EPIC Health Plan Senior |
$11.84
|
| Rate for Payer: Galaxy Health WC |
$25.16
|
| Rate for Payer: Global Benefits Group Commercial |
$17.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.72
|
| Rate for Payer: Multiplan Commercial |
$23.68
|
| Rate for Payer: Networks By Design Commercial |
$19.24
|
| Rate for Payer: Prime Health Services Commercial |
$25.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.80
|
| Rate for Payer: United Healthcare All Other HMO |
$14.80
|
| Rate for Payer: United Healthcare HMO Rider |
$14.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.16
|
| Rate for Payer: Vantage Medical Group Senior |
$25.16
|
|
|
HC SUTURE VICRYL 4-0 18" PS-2
|
Facility
|
IP
|
$29.60
|
|
| Hospital Charge Code |
901604233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.92 |
| Max. Negotiated Rate |
$25.16 |
| Rate for Payer: Adventist Health Commercial |
$5.92
|
| Rate for Payer: Cash Price |
$13.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.84
|
| Rate for Payer: EPIC Health Plan Senior |
$11.84
|
| Rate for Payer: Galaxy Health WC |
$25.16
|
| Rate for Payer: Global Benefits Group Commercial |
$17.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.10
|
| Rate for Payer: Multiplan Commercial |
$23.68
|
| Rate for Payer: Networks By Design Commercial |
$19.24
|
| Rate for Payer: Prime Health Services Commercial |
$25.16
|
|
|
HC SUTURE VICRYL 4-0 27" 109330
|
Facility
|
OP
|
$21.16
|
|
| Hospital Charge Code |
901694879
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$17.99 |
| Rate for Payer: Adventist Health Commercial |
$4.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.99
|
| Rate for Payer: Cash Price |
$9.52
|
| Rate for Payer: Cigna of CA HMO |
$13.54
|
| Rate for Payer: Cigna of CA PPO |
$15.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.46
|
| Rate for Payer: EPIC Health Plan Senior |
$8.46
|
| Rate for Payer: Galaxy Health WC |
$17.99
|
| Rate for Payer: Global Benefits Group Commercial |
$12.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.81
|
| Rate for Payer: Multiplan Commercial |
$16.93
|
| Rate for Payer: Networks By Design Commercial |
$13.75
|
| Rate for Payer: Prime Health Services Commercial |
$17.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.58
|
| Rate for Payer: United Healthcare All Other HMO |
$10.58
|
| Rate for Payer: United Healthcare HMO Rider |
$10.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.99
|
| Rate for Payer: Vantage Medical Group Senior |
$17.99
|
|
|
HC SUTURE VICRYL 4-0 27" 109330
|
Facility
|
IP
|
$21.16
|
|
| Hospital Charge Code |
901694879
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$17.99 |
| Rate for Payer: Adventist Health Commercial |
$4.23
|
| Rate for Payer: Cash Price |
$9.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.46
|
| Rate for Payer: EPIC Health Plan Senior |
$8.46
|
| Rate for Payer: Galaxy Health WC |
$17.99
|
| Rate for Payer: Global Benefits Group Commercial |
$12.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.08
|
| Rate for Payer: Multiplan Commercial |
$16.93
|
| Rate for Payer: Networks By Design Commercial |
$13.75
|
| Rate for Payer: Prime Health Services Commercial |
$17.99
|
|
|
HC SUTURE VICRYL 4-0 27" SH
|
Facility
|
OP
|
$16.48
|
|
| Hospital Charge Code |
901604301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$14.01 |
| Rate for Payer: Adventist Health Commercial |
$3.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.12
|
| Rate for Payer: Cash Price |
$7.42
|
| Rate for Payer: Cigna of CA HMO |
$10.55
|
| Rate for Payer: Cigna of CA PPO |
$12.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.59
|
| Rate for Payer: EPIC Health Plan Senior |
$6.59
|
| Rate for Payer: Galaxy Health WC |
$14.01
|
| Rate for Payer: Global Benefits Group Commercial |
$9.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.54
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.54
|
| Rate for Payer: Multiplan Commercial |
$13.18
|
| Rate for Payer: Networks By Design Commercial |
$10.71
|
| Rate for Payer: Prime Health Services Commercial |
$14.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.89
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.24
|
| Rate for Payer: United Healthcare All Other HMO |
$8.24
|
| Rate for Payer: United Healthcare HMO Rider |
$8.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.01
|
| Rate for Payer: Vantage Medical Group Senior |
$14.01
|
|
|
HC SUTURE VICRYL 4-0 27" SH
|
Facility
|
IP
|
$16.48
|
|
| Hospital Charge Code |
901604301
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$14.01 |
| Rate for Payer: Adventist Health Commercial |
$3.30
|
| Rate for Payer: Cash Price |
$7.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.59
|
| Rate for Payer: EPIC Health Plan Senior |
$6.59
|
| Rate for Payer: Galaxy Health WC |
$14.01
|
| Rate for Payer: Global Benefits Group Commercial |
$9.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.96
|
| Rate for Payer: Multiplan Commercial |
$13.18
|
| Rate for Payer: Networks By Design Commercial |
$10.71
|
| Rate for Payer: Prime Health Services Commercial |
$14.01
|
|
|
HC SUTURE VICRYL 4-0 CTD ANTIBAC
|
Facility
|
IP
|
$46.58
|
|
| Hospital Charge Code |
901604397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.32 |
| Max. Negotiated Rate |
$39.59 |
| Rate for Payer: Adventist Health Commercial |
$9.32
|
| Rate for Payer: Cash Price |
$20.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.63
|
| Rate for Payer: EPIC Health Plan Senior |
$18.63
|
| Rate for Payer: Galaxy Health WC |
$39.59
|
| Rate for Payer: Global Benefits Group Commercial |
$27.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.18
|
| Rate for Payer: Multiplan Commercial |
$37.26
|
| Rate for Payer: Networks By Design Commercial |
$30.28
|
| Rate for Payer: Prime Health Services Commercial |
$39.59
|
|
|
HC SUTURE VICRYL 4-0 CTD ANTIBAC
|
Facility
|
OP
|
$46.58
|
|
| Hospital Charge Code |
901604397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.32 |
| Max. Negotiated Rate |
$39.59 |
| Rate for Payer: Adventist Health Commercial |
$9.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$39.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.60
|
| Rate for Payer: Cash Price |
$20.96
|
| Rate for Payer: Cigna of CA HMO |
$29.81
|
| Rate for Payer: Cigna of CA PPO |
$34.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$39.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$39.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$39.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.63
|
| Rate for Payer: EPIC Health Plan Senior |
$18.63
|
| Rate for Payer: Galaxy Health WC |
$39.59
|
| Rate for Payer: Global Benefits Group Commercial |
$27.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$17.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$28.83
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.61
|
| Rate for Payer: Multiplan Commercial |
$37.26
|
| Rate for Payer: Networks By Design Commercial |
$30.28
|
| Rate for Payer: Prime Health Services Commercial |
$39.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.95
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.29
|
| Rate for Payer: United Healthcare All Other HMO |
$23.29
|
| Rate for Payer: United Healthcare HMO Rider |
$23.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$39.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$39.59
|
| Rate for Payer: Vantage Medical Group Senior |
$39.59
|
|
|
HC SUTURE VICRYL 4-0 FS1 117218
|
Facility
|
OP
|
$14.60
|
|
| Hospital Charge Code |
901694625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$12.41 |
| Rate for Payer: Adventist Health Commercial |
$2.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.97
|
| Rate for Payer: Cash Price |
$6.57
|
| Rate for Payer: Cigna of CA HMO |
$9.34
|
| Rate for Payer: Cigna of CA PPO |
$10.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.84
|
| Rate for Payer: EPIC Health Plan Senior |
$5.84
|
| Rate for Payer: Galaxy Health WC |
$12.41
|
| Rate for Payer: Global Benefits Group Commercial |
$8.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.22
|
| Rate for Payer: Multiplan Commercial |
$11.68
|
| Rate for Payer: Networks By Design Commercial |
$9.49
|
| Rate for Payer: Prime Health Services Commercial |
$12.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.30
|
| Rate for Payer: United Healthcare All Other HMO |
$7.30
|
| Rate for Payer: United Healthcare HMO Rider |
$7.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.41
|
| Rate for Payer: Vantage Medical Group Senior |
$12.41
|
|
|
HC SUTURE VICRYL 4-0 FS1 117218
|
Facility
|
IP
|
$14.60
|
|
| Hospital Charge Code |
901694625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$12.41 |
| Rate for Payer: Adventist Health Commercial |
$2.92
|
| Rate for Payer: Cash Price |
$6.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.84
|
| Rate for Payer: EPIC Health Plan Senior |
$5.84
|
| Rate for Payer: Galaxy Health WC |
$12.41
|
| Rate for Payer: Global Benefits Group Commercial |
$8.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.50
|
| Rate for Payer: Multiplan Commercial |
$11.68
|
| Rate for Payer: Networks By Design Commercial |
$9.49
|
| Rate for Payer: Prime Health Services Commercial |
$12.41
|
|
|
HC SUTURE VICRYL 4-0 P-3 1012
|
Facility
|
IP
|
$30.18
|
|
| Hospital Charge Code |
901694890
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.04 |
| Max. Negotiated Rate |
$25.65 |
| Rate for Payer: Adventist Health Commercial |
$6.04
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.07
|
| Rate for Payer: EPIC Health Plan Senior |
$12.07
|
| Rate for Payer: Galaxy Health WC |
$25.65
|
| Rate for Payer: Global Benefits Group Commercial |
$18.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.24
|
| Rate for Payer: Multiplan Commercial |
$24.14
|
| Rate for Payer: Networks By Design Commercial |
$19.62
|
| Rate for Payer: Prime Health Services Commercial |
$25.65
|
|
|
HC SUTURE VICRYL 4-0 P-3 1012
|
Facility
|
OP
|
$30.18
|
|
| Hospital Charge Code |
901694890
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.04 |
| Max. Negotiated Rate |
$25.65 |
| Rate for Payer: Adventist Health Commercial |
$6.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.53
|
| Rate for Payer: Cash Price |
$13.58
|
| Rate for Payer: Cigna of CA HMO |
$19.32
|
| Rate for Payer: Cigna of CA PPO |
$22.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.07
|
| Rate for Payer: EPIC Health Plan Senior |
$12.07
|
| Rate for Payer: Galaxy Health WC |
$25.65
|
| Rate for Payer: Global Benefits Group Commercial |
$18.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.13
|
| Rate for Payer: Multiplan Commercial |
$24.14
|
| Rate for Payer: Networks By Design Commercial |
$19.62
|
| Rate for Payer: Prime Health Services Commercial |
$25.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.09
|
| Rate for Payer: United Healthcare All Other HMO |
$15.09
|
| Rate for Payer: United Healthcare HMO Rider |
$15.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.65
|
| Rate for Payer: Vantage Medical Group Senior |
$25.65
|
|
|
HC SUTURE VICRYL 4-0 PS-2 119576
|
Facility
|
IP
|
$59.94
|
|
| Hospital Charge Code |
901694892
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$50.95 |
| Rate for Payer: Adventist Health Commercial |
$11.99
|
| Rate for Payer: Cash Price |
$26.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.98
|
| Rate for Payer: EPIC Health Plan Senior |
$23.98
|
| Rate for Payer: Galaxy Health WC |
$50.95
|
| Rate for Payer: Global Benefits Group Commercial |
$35.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.39
|
| Rate for Payer: Multiplan Commercial |
$47.95
|
| Rate for Payer: Networks By Design Commercial |
$38.96
|
| Rate for Payer: Prime Health Services Commercial |
$50.95
|
|
|
HC SUTURE VICRYL 4-0 PS-2 119576
|
Facility
|
OP
|
$59.94
|
|
| Hospital Charge Code |
901694892
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$11.99 |
| Max. Negotiated Rate |
$50.95 |
| Rate for Payer: Adventist Health Commercial |
$11.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$50.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$32.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$44.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.81
|
| Rate for Payer: Cash Price |
$26.97
|
| Rate for Payer: Cigna of CA HMO |
$38.36
|
| Rate for Payer: Cigna of CA PPO |
$44.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$50.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$50.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$50.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.98
|
| Rate for Payer: EPIC Health Plan Senior |
$23.98
|
| Rate for Payer: Galaxy Health WC |
$50.95
|
| Rate for Payer: Global Benefits Group Commercial |
$35.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$39.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22.84
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$41.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$41.96
|
| Rate for Payer: Multiplan Commercial |
$47.95
|
| Rate for Payer: Networks By Design Commercial |
$38.96
|
| Rate for Payer: Prime Health Services Commercial |
$50.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$35.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$35.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$29.97
|
| Rate for Payer: United Healthcare All Other HMO |
$29.97
|
| Rate for Payer: United Healthcare HMO Rider |
$29.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$29.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$50.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$50.95
|
| Rate for Payer: Vantage Medical Group Senior |
$50.95
|
|
|
HC SUTURE VICRYL 4-0 PS-2 18IN
|
Facility
|
OP
|
$42.39
|
|
| Hospital Charge Code |
901698853
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$36.03 |
| Rate for Payer: Adventist Health Commercial |
$8.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.79
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.03
|
| Rate for Payer: Cash Price |
$19.08
|
| Rate for Payer: Cigna of CA HMO |
$27.13
|
| Rate for Payer: Cigna of CA PPO |
$31.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$36.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.96
|
| Rate for Payer: EPIC Health Plan Senior |
$16.96
|
| Rate for Payer: Galaxy Health WC |
$36.03
|
| Rate for Payer: Global Benefits Group Commercial |
$25.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.67
|
| Rate for Payer: Multiplan Commercial |
$33.91
|
| Rate for Payer: Networks By Design Commercial |
$27.55
|
| Rate for Payer: Prime Health Services Commercial |
$36.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.20
|
| Rate for Payer: United Healthcare All Other HMO |
$21.20
|
| Rate for Payer: United Healthcare HMO Rider |
$21.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.03
|
| Rate for Payer: Vantage Medical Group Senior |
$36.03
|
|
|
HC SUTURE VICRYL 4-0 PS-2 18IN
|
Facility
|
IP
|
$42.39
|
|
| Hospital Charge Code |
901698853
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.48 |
| Max. Negotiated Rate |
$36.03 |
| Rate for Payer: Adventist Health Commercial |
$8.48
|
| Rate for Payer: Cash Price |
$19.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.96
|
| Rate for Payer: EPIC Health Plan Senior |
$16.96
|
| Rate for Payer: Galaxy Health WC |
$36.03
|
| Rate for Payer: Global Benefits Group Commercial |
$25.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.17
|
| Rate for Payer: Multiplan Commercial |
$33.91
|
| Rate for Payer: Networks By Design Commercial |
$27.55
|
| Rate for Payer: Prime Health Services Commercial |
$36.03
|
|
