|
HC SUTURE CHROMIC O 27" 108242
|
Facility
|
OP
|
$102.30
|
|
| Hospital Charge Code |
901693101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$86.95 |
| Rate for Payer: Adventist Health Commercial |
$20.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$67.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$86.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$56.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$76.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.65
|
| Rate for Payer: Cash Price |
$46.04
|
| Rate for Payer: Cigna of CA HMO |
$65.47
|
| Rate for Payer: Cigna of CA PPO |
$75.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$86.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$86.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$86.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.92
|
| Rate for Payer: EPIC Health Plan Senior |
$40.92
|
| Rate for Payer: Galaxy Health WC |
$86.95
|
| Rate for Payer: Global Benefits Group Commercial |
$61.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$71.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$71.61
|
| Rate for Payer: Multiplan Commercial |
$81.84
|
| Rate for Payer: Networks By Design Commercial |
$66.50
|
| Rate for Payer: Prime Health Services Commercial |
$86.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$61.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$61.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.15
|
| Rate for Payer: United Healthcare All Other HMO |
$51.15
|
| Rate for Payer: United Healthcare HMO Rider |
$51.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$51.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$86.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$86.95
|
| Rate for Payer: Vantage Medical Group Senior |
$86.95
|
|
|
HC SUTURE CHROMIC O 27" 108242
|
Facility
|
IP
|
$102.30
|
|
| Hospital Charge Code |
901693101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$20.46 |
| Max. Negotiated Rate |
$86.95 |
| Rate for Payer: Adventist Health Commercial |
$20.46
|
| Rate for Payer: Cash Price |
$46.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$71.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$40.92
|
| Rate for Payer: EPIC Health Plan Senior |
$40.92
|
| Rate for Payer: Galaxy Health WC |
$86.95
|
| Rate for Payer: Global Benefits Group Commercial |
$61.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$64.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$60.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.55
|
| Rate for Payer: Multiplan Commercial |
$81.84
|
| Rate for Payer: Networks By Design Commercial |
$66.50
|
| Rate for Payer: Prime Health Services Commercial |
$86.95
|
|
|
HC SUTURE DERMALON 3-0 18" C-14
|
Facility
|
IP
|
$79.70
|
|
| Hospital Charge Code |
901601298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.94 |
| Max. Negotiated Rate |
$67.75 |
| Rate for Payer: Adventist Health Commercial |
$15.94
|
| Rate for Payer: Cash Price |
$35.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$55.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.88
|
| Rate for Payer: EPIC Health Plan Senior |
$31.88
|
| Rate for Payer: Galaxy Health WC |
$67.75
|
| Rate for Payer: Global Benefits Group Commercial |
$47.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$50.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.13
|
| Rate for Payer: Multiplan Commercial |
$63.76
|
| Rate for Payer: Networks By Design Commercial |
$51.80
|
| Rate for Payer: Prime Health Services Commercial |
$67.75
|
|
|
HC SUTURE DERMALON 3-0 18" C-14
|
Facility
|
OP
|
$79.70
|
|
| Hospital Charge Code |
901601298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.94 |
| Max. Negotiated Rate |
$67.75 |
| Rate for Payer: Adventist Health Commercial |
$15.94
|
| Rate for Payer: Aetna of CA HMO/PPO |
$52.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$67.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$51.14
|
| Rate for Payer: Cash Price |
$35.86
|
| Rate for Payer: Cigna of CA HMO |
$51.01
|
| Rate for Payer: Cigna of CA PPO |
$58.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$67.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$55.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.88
|
| Rate for Payer: EPIC Health Plan Senior |
$31.88
|
| Rate for Payer: Galaxy Health WC |
$67.75
|
| Rate for Payer: Global Benefits Group Commercial |
$47.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$50.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$28.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$47.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$55.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55.79
|
| Rate for Payer: Multiplan Commercial |
$63.76
|
| Rate for Payer: Networks By Design Commercial |
$51.80
|
| Rate for Payer: Prime Health Services Commercial |
$67.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$47.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$39.85
|
| Rate for Payer: United Healthcare All Other HMO |
$39.85
|
| Rate for Payer: United Healthcare HMO Rider |
$39.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$67.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.75
|
| Rate for Payer: Vantage Medical Group Senior |
$67.75
|
|
|
HC SUTURE ETHILON 2-0 18" FS
|
Facility
|
IP
|
$20.66
|
|
| Hospital Charge Code |
901604105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: EPIC Health Plan Senior |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.96
|
| Rate for Payer: Multiplan Commercial |
$16.53
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
|
|
HC SUTURE ETHILON 2-0 18" FS
|
Facility
|
OP
|
$20.66
|
|
| Hospital Charge Code |
901604105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.13 |
| Max. Negotiated Rate |
$17.56 |
| Rate for Payer: Cigna of CA PPO |
$15.29
|
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.26
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Cigna of CA HMO |
$13.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.26
|
| Rate for Payer: EPIC Health Plan Senior |
$8.26
|
| Rate for Payer: Galaxy Health WC |
$17.56
|
| Rate for Payer: Global Benefits Group Commercial |
$12.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.46
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.46
|
| Rate for Payer: Multiplan Commercial |
$16.53
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.33
|
| Rate for Payer: United Healthcare All Other HMO |
$10.33
|
| Rate for Payer: United Healthcare HMO Rider |
$10.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.56
|
| Rate for Payer: Vantage Medical Group Senior |
$17.56
|
|
|
HC SUTURE ETHILON 3-0 18" PS-1
|
Facility
|
OP
|
$45.84
|
|
| Hospital Charge Code |
901604016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$38.96 |
| Rate for Payer: Adventist Health Commercial |
$9.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$25.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$34.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.42
|
| Rate for Payer: Cash Price |
$20.63
|
| Rate for Payer: Cigna of CA HMO |
$29.34
|
| Rate for Payer: Cigna of CA PPO |
$33.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$38.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$38.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.34
|
| Rate for Payer: EPIC Health Plan Senior |
$18.34
|
| Rate for Payer: Galaxy Health WC |
$38.96
|
| Rate for Payer: Global Benefits Group Commercial |
$27.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$29.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$32.09
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$32.09
|
| Rate for Payer: Multiplan Commercial |
$36.67
|
| Rate for Payer: Networks By Design Commercial |
$29.80
|
| Rate for Payer: Prime Health Services Commercial |
$38.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.92
|
| Rate for Payer: United Healthcare All Other HMO |
$22.92
|
| Rate for Payer: United Healthcare HMO Rider |
$22.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.96
|
| Rate for Payer: Vantage Medical Group Senior |
$38.96
|
|
|
HC SUTURE ETHILON 3-0 18" PS-1
|
Facility
|
IP
|
$45.84
|
|
| Hospital Charge Code |
901604016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$38.96 |
| Rate for Payer: Adventist Health Commercial |
$9.17
|
| Rate for Payer: Cash Price |
$20.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$32.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.34
|
| Rate for Payer: EPIC Health Plan Senior |
$18.34
|
| Rate for Payer: Galaxy Health WC |
$38.96
|
| Rate for Payer: Global Benefits Group Commercial |
$27.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$29.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$27.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.00
|
| Rate for Payer: Multiplan Commercial |
$36.67
|
| Rate for Payer: Networks By Design Commercial |
$29.80
|
| Rate for Payer: Prime Health Services Commercial |
$38.96
|
|
|
HC SUTURE ETHILON 4-0 18"
|
Facility
|
IP
|
$41.98
|
|
| Hospital Charge Code |
901603481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$35.68 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Cash Price |
$18.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.79
|
| Rate for Payer: EPIC Health Plan Senior |
$16.79
|
| Rate for Payer: Galaxy Health WC |
$35.68
|
| Rate for Payer: Global Benefits Group Commercial |
$25.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.08
|
| Rate for Payer: Multiplan Commercial |
$33.58
|
| Rate for Payer: Networks By Design Commercial |
$27.29
|
| Rate for Payer: Prime Health Services Commercial |
$35.68
|
|
|
HC SUTURE ETHILON 4-0 18"
|
Facility
|
OP
|
$41.98
|
|
| Hospital Charge Code |
901603481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$35.68 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35.68
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.94
|
| Rate for Payer: Cash Price |
$18.89
|
| Rate for Payer: Cigna of CA HMO |
$26.87
|
| Rate for Payer: Cigna of CA PPO |
$31.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.68
|
| Rate for Payer: Dignity Health Medi-Cal |
$35.68
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.79
|
| Rate for Payer: EPIC Health Plan Senior |
$16.79
|
| Rate for Payer: Galaxy Health WC |
$35.68
|
| Rate for Payer: Global Benefits Group Commercial |
$25.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.39
|
| Rate for Payer: Multiplan Commercial |
$33.58
|
| Rate for Payer: Networks By Design Commercial |
$27.29
|
| Rate for Payer: Prime Health Services Commercial |
$35.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.99
|
| Rate for Payer: United Healthcare All Other HMO |
$20.99
|
| Rate for Payer: United Healthcare HMO Rider |
$20.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$35.68
|
| Rate for Payer: Vantage Medical Group Senior |
$35.68
|
|
|
HC SUTURE ETHILON 4-0 18" P-3
|
Facility
|
IP
|
$42.23
|
|
| Hospital Charge Code |
901603977
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$35.90 |
| Rate for Payer: Adventist Health Commercial |
$8.45
|
| Rate for Payer: Cash Price |
$19.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.89
|
| Rate for Payer: EPIC Health Plan Senior |
$16.89
|
| Rate for Payer: Galaxy Health WC |
$35.90
|
| Rate for Payer: Global Benefits Group Commercial |
$25.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.14
|
| Rate for Payer: Multiplan Commercial |
$33.78
|
| Rate for Payer: Networks By Design Commercial |
$27.45
|
| Rate for Payer: Prime Health Services Commercial |
$35.90
|
|
|
HC SUTURE ETHILON 4-0 18" P-3
|
Facility
|
OP
|
$42.23
|
|
| Hospital Charge Code |
901603977
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$35.90 |
| Rate for Payer: Adventist Health Commercial |
$8.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.70
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27.10
|
| Rate for Payer: Cash Price |
$19.00
|
| Rate for Payer: Cigna of CA HMO |
$27.03
|
| Rate for Payer: Cigna of CA PPO |
$31.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$35.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.89
|
| Rate for Payer: EPIC Health Plan Senior |
$16.89
|
| Rate for Payer: Galaxy Health WC |
$35.90
|
| Rate for Payer: Global Benefits Group Commercial |
$25.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.56
|
| Rate for Payer: Multiplan Commercial |
$33.78
|
| Rate for Payer: Networks By Design Commercial |
$27.45
|
| Rate for Payer: Prime Health Services Commercial |
$35.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.11
|
| Rate for Payer: United Healthcare All Other HMO |
$21.11
|
| Rate for Payer: United Healthcare HMO Rider |
$21.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$35.90
|
| Rate for Payer: Vantage Medical Group Senior |
$35.90
|
|
|
HC SUTURE ETHILON 4-0 18" PC-1
|
Facility
|
OP
|
$43.71
|
|
| Hospital Charge Code |
901601299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$37.15 |
| Rate for Payer: Adventist Health Commercial |
$8.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.05
|
| Rate for Payer: Cash Price |
$19.67
|
| Rate for Payer: Cigna of CA HMO |
$27.97
|
| Rate for Payer: Cigna of CA PPO |
$32.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$37.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Senior |
$17.48
|
| Rate for Payer: Galaxy Health WC |
$37.15
|
| Rate for Payer: Global Benefits Group Commercial |
$26.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.60
|
| Rate for Payer: Multiplan Commercial |
$34.97
|
| Rate for Payer: Networks By Design Commercial |
$28.41
|
| Rate for Payer: Prime Health Services Commercial |
$37.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.86
|
| Rate for Payer: United Healthcare All Other HMO |
$21.86
|
| Rate for Payer: United Healthcare HMO Rider |
$21.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.15
|
| Rate for Payer: Vantage Medical Group Senior |
$37.15
|
|
|
HC SUTURE ETHILON 4-0 18" PC-1
|
Facility
|
IP
|
$43.71
|
|
| Hospital Charge Code |
901601299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$37.15 |
| Rate for Payer: Adventist Health Commercial |
$8.74
|
| Rate for Payer: Cash Price |
$19.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.48
|
| Rate for Payer: EPIC Health Plan Senior |
$17.48
|
| Rate for Payer: Galaxy Health WC |
$37.15
|
| Rate for Payer: Global Benefits Group Commercial |
$26.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$27.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$25.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.49
|
| Rate for Payer: Multiplan Commercial |
$34.97
|
| Rate for Payer: Networks By Design Commercial |
$28.41
|
| Rate for Payer: Prime Health Services Commercial |
$37.15
|
|
|
HC SUTURE ETHILON 4-0 18" PC-5
|
Facility
|
OP
|
$29.85
|
|
| Hospital Charge Code |
901604015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$25.37 |
| Rate for Payer: Adventist Health Commercial |
$5.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.15
|
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Cigna of CA HMO |
$19.10
|
| Rate for Payer: Cigna of CA PPO |
$22.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.94
|
| Rate for Payer: EPIC Health Plan Senior |
$11.94
|
| Rate for Payer: Galaxy Health WC |
$25.37
|
| Rate for Payer: Global Benefits Group Commercial |
$17.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.89
|
| Rate for Payer: Multiplan Commercial |
$23.88
|
| Rate for Payer: Networks By Design Commercial |
$19.40
|
| Rate for Payer: Prime Health Services Commercial |
$25.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.93
|
| Rate for Payer: United Healthcare All Other HMO |
$14.93
|
| Rate for Payer: United Healthcare HMO Rider |
$14.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.37
|
| Rate for Payer: Vantage Medical Group Senior |
$25.37
|
|
|
HC SUTURE ETHILON 4-0 18" PC-5
|
Facility
|
IP
|
$29.85
|
|
| Hospital Charge Code |
901604015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.97 |
| Max. Negotiated Rate |
$25.37 |
| Rate for Payer: Adventist Health Commercial |
$5.97
|
| Rate for Payer: Cash Price |
$13.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.94
|
| Rate for Payer: EPIC Health Plan Senior |
$11.94
|
| Rate for Payer: Galaxy Health WC |
$25.37
|
| Rate for Payer: Global Benefits Group Commercial |
$17.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.16
|
| Rate for Payer: Multiplan Commercial |
$23.88
|
| Rate for Payer: Networks By Design Commercial |
$19.40
|
| Rate for Payer: Prime Health Services Commercial |
$25.37
|
|
|
HC SUTURE ETHILON 4-0 18" PS-4
|
Facility
|
OP
|
$39.77
|
|
| Hospital Charge Code |
901601309
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.52
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Cigna of CA HMO |
$25.45
|
| Rate for Payer: Cigna of CA PPO |
$29.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.84
|
| Rate for Payer: Multiplan Commercial |
$31.82
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.89
|
| Rate for Payer: United Healthcare All Other HMO |
$19.89
|
| Rate for Payer: United Healthcare HMO Rider |
$19.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.80
|
| Rate for Payer: Vantage Medical Group Senior |
$33.80
|
|
|
HC SUTURE ETHILON 4-0 18" PS-4
|
Facility
|
IP
|
$39.77
|
|
| Hospital Charge Code |
901601309
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.54
|
| Rate for Payer: Multiplan Commercial |
$31.82
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
|
|
HC SUTURE ETHILON 5-0 18" P-3
|
Facility
|
OP
|
$39.77
|
|
| Hospital Charge Code |
901600387
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.52
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Cigna of CA HMO |
$25.45
|
| Rate for Payer: Cigna of CA PPO |
$29.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$27.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$27.84
|
| Rate for Payer: Multiplan Commercial |
$31.82
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.89
|
| Rate for Payer: United Healthcare All Other HMO |
$19.89
|
| Rate for Payer: United Healthcare HMO Rider |
$19.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.80
|
| Rate for Payer: Vantage Medical Group Senior |
$33.80
|
|
|
HC SUTURE ETHILON 5-0 18" P-3
|
Facility
|
IP
|
$39.77
|
|
| Hospital Charge Code |
901600387
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$33.80 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.91
|
| Rate for Payer: EPIC Health Plan Senior |
$15.91
|
| Rate for Payer: Galaxy Health WC |
$33.80
|
| Rate for Payer: Global Benefits Group Commercial |
$23.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.54
|
| Rate for Payer: Multiplan Commercial |
$31.82
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
|
|
HC SUTURE ETHILON 5-0 18" P3
|
Facility
|
IP
|
$44.12
|
|
| Hospital Charge Code |
901604014
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Adventist Health Commercial |
$8.82
|
| Rate for Payer: Cash Price |
$19.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.65
|
| Rate for Payer: EPIC Health Plan Senior |
$17.65
|
| Rate for Payer: Galaxy Health WC |
$37.50
|
| Rate for Payer: Global Benefits Group Commercial |
$26.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$28.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$26.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.59
|
| Rate for Payer: Multiplan Commercial |
$35.30
|
| Rate for Payer: Networks By Design Commercial |
$28.68
|
| Rate for Payer: Prime Health Services Commercial |
$37.50
|
|
|
HC SUTURE ETHILON 5-0 18" P3
|
Facility
|
OP
|
$44.12
|
|
| Hospital Charge Code |
901604014
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$37.50 |
| Rate for Payer: Vantage Medical Group Senior |
$37.50
|
| Rate for Payer: Adventist Health Commercial |
$8.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$28.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.31
|
| Rate for Payer: Cash Price |
$19.85
|
| Rate for Payer: Cigna of CA HMO |
$28.24
|
| Rate for Payer: Cigna of CA PPO |
$32.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$37.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$30.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.65
|
| Rate for Payer: EPIC Health Plan Senior |
$17.65
|
| Rate for Payer: Galaxy Health WC |
$37.50
|
| Rate for Payer: Global Benefits Group Commercial |
$26.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$28.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$16.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$26.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$30.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$30.88
|
| Rate for Payer: Multiplan Commercial |
$35.30
|
| Rate for Payer: Networks By Design Commercial |
$28.68
|
| Rate for Payer: Prime Health Services Commercial |
$37.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.06
|
| Rate for Payer: United Healthcare All Other HMO |
$22.06
|
| Rate for Payer: United Healthcare HMO Rider |
$22.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.50
|
|
|
HC SUTURE ETHILON 5-0 18" PS2
|
Facility
|
OP
|
$40.18
|
|
| Hospital Charge Code |
901600856
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.04 |
| Max. Negotiated Rate |
$34.15 |
| Rate for Payer: Adventist Health Commercial |
$8.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.78
|
| Rate for Payer: Cash Price |
$18.08
|
| Rate for Payer: Cigna of CA HMO |
$25.72
|
| Rate for Payer: Cigna of CA PPO |
$29.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.07
|
| Rate for Payer: EPIC Health Plan Senior |
$16.07
|
| Rate for Payer: Galaxy Health WC |
$34.15
|
| Rate for Payer: Global Benefits Group Commercial |
$24.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.13
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.13
|
| Rate for Payer: Multiplan Commercial |
$32.14
|
| Rate for Payer: Networks By Design Commercial |
$26.12
|
| Rate for Payer: Prime Health Services Commercial |
$34.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.09
|
| Rate for Payer: United Healthcare All Other HMO |
$20.09
|
| Rate for Payer: United Healthcare HMO Rider |
$20.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.15
|
| Rate for Payer: Vantage Medical Group Senior |
$34.15
|
|
|
HC SUTURE ETHILON 5-0 18" PS2
|
Facility
|
IP
|
$40.18
|
|
| Hospital Charge Code |
901600856
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.04 |
| Max. Negotiated Rate |
$34.15 |
| Rate for Payer: Adventist Health Commercial |
$8.04
|
| Rate for Payer: Cash Price |
$18.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.07
|
| Rate for Payer: EPIC Health Plan Senior |
$16.07
|
| Rate for Payer: Galaxy Health WC |
$34.15
|
| Rate for Payer: Global Benefits Group Commercial |
$24.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.64
|
| Rate for Payer: Multiplan Commercial |
$32.14
|
| Rate for Payer: Networks By Design Commercial |
$26.12
|
| Rate for Payer: Prime Health Services Commercial |
$34.15
|
|
|
HC SUTURE ETHILON 5-0 P-3
|
Facility
|
IP
|
$27.59
|
|
| Hospital Charge Code |
901691500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$23.45 |
| Rate for Payer: Adventist Health Commercial |
$5.52
|
| Rate for Payer: Cash Price |
$12.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.04
|
| Rate for Payer: EPIC Health Plan Senior |
$11.04
|
| Rate for Payer: Galaxy Health WC |
$23.45
|
| Rate for Payer: Global Benefits Group Commercial |
$16.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.62
|
| Rate for Payer: Multiplan Commercial |
$22.07
|
| Rate for Payer: Networks By Design Commercial |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$23.45
|
|
