|
HC SUTURE MONOCCRYL 4-0 PS-2 18"
|
Facility
|
IP
|
$60.76
|
|
| Hospital Charge Code |
901694642
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.15 |
| Max. Negotiated Rate |
$51.65 |
| Rate for Payer: Adventist Health Commercial |
$12.15
|
| Rate for Payer: Cash Price |
$27.34
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.30
|
| Rate for Payer: EPIC Health Plan Senior |
$24.30
|
| Rate for Payer: Galaxy Health WC |
$51.65
|
| Rate for Payer: Global Benefits Group Commercial |
$36.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.58
|
| Rate for Payer: Multiplan Commercial |
$48.61
|
| Rate for Payer: Networks By Design Commercial |
$39.49
|
| Rate for Payer: Prime Health Services Commercial |
$51.65
|
|
|
HC SUTURE MONOCCRYL 4-0 PS-2 18"
|
Facility
|
OP
|
$60.76
|
|
| Hospital Charge Code |
901694642
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.15 |
| Max. Negotiated Rate |
$51.65 |
| Rate for Payer: Adventist Health Commercial |
$12.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.99
|
| Rate for Payer: Cash Price |
$27.34
|
| Rate for Payer: Cigna of CA HMO |
$38.89
|
| Rate for Payer: Cigna of CA PPO |
$44.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.30
|
| Rate for Payer: EPIC Health Plan Senior |
$24.30
|
| Rate for Payer: Galaxy Health WC |
$51.65
|
| Rate for Payer: Global Benefits Group Commercial |
$36.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.53
|
| Rate for Payer: Multiplan Commercial |
$48.61
|
| Rate for Payer: Networks By Design Commercial |
$39.49
|
| Rate for Payer: Prime Health Services Commercial |
$51.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.38
|
| Rate for Payer: United Healthcare All Other HMO |
$30.38
|
| Rate for Payer: United Healthcare HMO Rider |
$30.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.65
|
| Rate for Payer: Vantage Medical Group Senior |
$51.65
|
|
|
HC SUTURE MONOCRYL 3-0 18" PS-2
|
Facility
|
IP
|
$60.11
|
|
| Hospital Charge Code |
901694884
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.02 |
| Max. Negotiated Rate |
$51.09 |
| Rate for Payer: Adventist Health Commercial |
$12.02
|
| Rate for Payer: Cash Price |
$27.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.04
|
| Rate for Payer: EPIC Health Plan Senior |
$24.04
|
| Rate for Payer: Galaxy Health WC |
$51.09
|
| Rate for Payer: Global Benefits Group Commercial |
$36.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.43
|
| Rate for Payer: Multiplan Commercial |
$48.09
|
| Rate for Payer: Networks By Design Commercial |
$39.07
|
| Rate for Payer: Prime Health Services Commercial |
$51.09
|
|
|
HC SUTURE MONOCRYL 3-0 18" PS-2
|
Facility
|
OP
|
$60.11
|
|
| Hospital Charge Code |
901694884
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.02 |
| Max. Negotiated Rate |
$51.09 |
| Rate for Payer: Adventist Health Commercial |
$12.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.57
|
| Rate for Payer: Cash Price |
$27.05
|
| Rate for Payer: Cigna of CA HMO |
$38.47
|
| Rate for Payer: Cigna of CA PPO |
$44.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.04
|
| Rate for Payer: EPIC Health Plan Senior |
$24.04
|
| Rate for Payer: Galaxy Health WC |
$51.09
|
| Rate for Payer: Global Benefits Group Commercial |
$36.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.08
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.08
|
| Rate for Payer: Multiplan Commercial |
$48.09
|
| Rate for Payer: Networks By Design Commercial |
$39.07
|
| Rate for Payer: Prime Health Services Commercial |
$51.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.05
|
| Rate for Payer: United Healthcare All Other HMO |
$30.05
|
| Rate for Payer: United Healthcare HMO Rider |
$30.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.09
|
| Rate for Payer: Vantage Medical Group Senior |
$51.09
|
|
|
HC SUTURE MONOCRYL 3-0 27" MCP936H
|
Facility
|
IP
|
$66.09
|
|
| Hospital Charge Code |
901691015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Adventist Health Commercial |
$13.22
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.44
|
| Rate for Payer: EPIC Health Plan Senior |
$26.44
|
| Rate for Payer: Galaxy Health WC |
$56.18
|
| Rate for Payer: Global Benefits Group Commercial |
$39.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.86
|
| Rate for Payer: Multiplan Commercial |
$52.87
|
| Rate for Payer: Networks By Design Commercial |
$42.96
|
| Rate for Payer: Prime Health Services Commercial |
$56.18
|
|
|
HC SUTURE MONOCRYL 3-0 27" MCP936H
|
Facility
|
OP
|
$66.09
|
|
| Hospital Charge Code |
901691015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.22 |
| Max. Negotiated Rate |
$56.18 |
| Rate for Payer: Adventist Health Commercial |
$13.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.41
|
| Rate for Payer: Cash Price |
$29.74
|
| Rate for Payer: Cigna of CA HMO |
$42.30
|
| Rate for Payer: Cigna of CA PPO |
$48.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.44
|
| Rate for Payer: EPIC Health Plan Senior |
$26.44
|
| Rate for Payer: Galaxy Health WC |
$56.18
|
| Rate for Payer: Global Benefits Group Commercial |
$39.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.26
|
| Rate for Payer: Multiplan Commercial |
$52.87
|
| Rate for Payer: Networks By Design Commercial |
$42.96
|
| Rate for Payer: Prime Health Services Commercial |
$56.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.05
|
| Rate for Payer: United Healthcare All Other HMO |
$33.05
|
| Rate for Payer: United Healthcare HMO Rider |
$33.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.18
|
| Rate for Payer: Vantage Medical Group Senior |
$56.18
|
|
|
HC SUTURE MONOCRYL 4-0 227388
|
Facility
|
OP
|
$60.84
|
|
| Hospital Charge Code |
901691009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.17 |
| Max. Negotiated Rate |
$51.71 |
| Rate for Payer: Adventist Health Commercial |
$12.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.63
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.04
|
| Rate for Payer: Cash Price |
$27.38
|
| Rate for Payer: Cigna of CA HMO |
$38.94
|
| Rate for Payer: Cigna of CA PPO |
$45.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.34
|
| Rate for Payer: EPIC Health Plan Senior |
$24.34
|
| Rate for Payer: Galaxy Health WC |
$51.71
|
| Rate for Payer: Global Benefits Group Commercial |
$36.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.59
|
| Rate for Payer: Multiplan Commercial |
$48.67
|
| Rate for Payer: Networks By Design Commercial |
$39.55
|
| Rate for Payer: Prime Health Services Commercial |
$51.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.42
|
| Rate for Payer: United Healthcare All Other HMO |
$30.42
|
| Rate for Payer: United Healthcare HMO Rider |
$30.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.71
|
| Rate for Payer: Vantage Medical Group Senior |
$51.71
|
|
|
HC SUTURE MONOCRYL 4-0 227388
|
Facility
|
IP
|
$60.84
|
|
| Hospital Charge Code |
901691009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.17 |
| Max. Negotiated Rate |
$51.71 |
| Rate for Payer: Adventist Health Commercial |
$12.17
|
| Rate for Payer: Cash Price |
$27.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.34
|
| Rate for Payer: EPIC Health Plan Senior |
$24.34
|
| Rate for Payer: Galaxy Health WC |
$51.71
|
| Rate for Payer: Global Benefits Group Commercial |
$36.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.60
|
| Rate for Payer: Multiplan Commercial |
$48.67
|
| Rate for Payer: Networks By Design Commercial |
$39.55
|
| Rate for Payer: Prime Health Services Commercial |
$51.71
|
|
|
HC SUTURE MONOCRYL 4-0 PS-2
|
Facility
|
IP
|
$63.14
|
|
| Hospital Charge Code |
901694885
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$53.67 |
| Rate for Payer: Adventist Health Commercial |
$12.63
|
| Rate for Payer: Cash Price |
$28.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.26
|
| Rate for Payer: EPIC Health Plan Senior |
$25.26
|
| Rate for Payer: Galaxy Health WC |
$53.67
|
| Rate for Payer: Global Benefits Group Commercial |
$37.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.15
|
| Rate for Payer: Multiplan Commercial |
$50.51
|
| Rate for Payer: Networks By Design Commercial |
$41.04
|
| Rate for Payer: Prime Health Services Commercial |
$53.67
|
|
|
HC SUTURE MONOCRYL 4-0 PS-2
|
Facility
|
OP
|
$63.14
|
|
| Hospital Charge Code |
901694885
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$53.67 |
| Rate for Payer: Adventist Health Commercial |
$12.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$41.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$53.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.52
|
| Rate for Payer: Cash Price |
$28.41
|
| Rate for Payer: Cigna of CA HMO |
$40.41
|
| Rate for Payer: Cigna of CA PPO |
$46.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$53.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$53.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$53.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.26
|
| Rate for Payer: EPIC Health Plan Senior |
$25.26
|
| Rate for Payer: Galaxy Health WC |
$53.67
|
| Rate for Payer: Global Benefits Group Commercial |
$37.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.20
|
| Rate for Payer: Multiplan Commercial |
$50.51
|
| Rate for Payer: Networks By Design Commercial |
$41.04
|
| Rate for Payer: Prime Health Services Commercial |
$53.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.57
|
| Rate for Payer: United Healthcare All Other HMO |
$31.57
|
| Rate for Payer: United Healthcare HMO Rider |
$31.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$53.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$53.67
|
| Rate for Payer: Vantage Medical Group Senior |
$53.67
|
|
|
HC SUTURE MONOCRYL 5-0 227404
|
Facility
|
IP
|
$66.01
|
|
| Hospital Charge Code |
901691008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$56.11 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.11
|
| Rate for Payer: Global Benefits Group Commercial |
$39.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.84
|
| Rate for Payer: Multiplan Commercial |
$52.81
|
| Rate for Payer: Networks By Design Commercial |
$42.91
|
| Rate for Payer: Prime Health Services Commercial |
$56.11
|
|
|
HC SUTURE MONOCRYL 5-0 227404
|
Facility
|
OP
|
$66.01
|
|
| Hospital Charge Code |
901691008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$56.11 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.36
|
| Rate for Payer: Cash Price |
$29.70
|
| Rate for Payer: Cigna of CA HMO |
$42.25
|
| Rate for Payer: Cigna of CA PPO |
$48.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.11
|
| Rate for Payer: Global Benefits Group Commercial |
$39.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.21
|
| Rate for Payer: Multiplan Commercial |
$52.81
|
| Rate for Payer: Networks By Design Commercial |
$42.91
|
| Rate for Payer: Prime Health Services Commercial |
$56.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.01
|
| Rate for Payer: United Healthcare All Other HMO |
$33.01
|
| Rate for Payer: United Healthcare HMO Rider |
$33.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.11
|
| Rate for Payer: Vantage Medical Group Senior |
$56.11
|
|
|
HC SUTURE MONOCRYL 5-0 P-3
|
Facility
|
IP
|
$32.96
|
|
| Hospital Charge Code |
901694941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$28.02 |
| Rate for Payer: Adventist Health Commercial |
$6.59
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.18
|
| Rate for Payer: EPIC Health Plan Senior |
$13.18
|
| Rate for Payer: Galaxy Health WC |
$28.02
|
| Rate for Payer: Global Benefits Group Commercial |
$19.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.91
|
| Rate for Payer: Multiplan Commercial |
$26.37
|
| Rate for Payer: Networks By Design Commercial |
$21.42
|
| Rate for Payer: Prime Health Services Commercial |
$28.02
|
|
|
HC SUTURE MONOCRYL 5-0 P-3
|
Facility
|
OP
|
$32.96
|
|
| Hospital Charge Code |
901694941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$28.02 |
| Rate for Payer: Adventist Health Commercial |
$6.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.15
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Cigna of CA HMO |
$21.09
|
| Rate for Payer: Cigna of CA PPO |
$24.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.18
|
| Rate for Payer: EPIC Health Plan Senior |
$13.18
|
| Rate for Payer: Galaxy Health WC |
$28.02
|
| Rate for Payer: Global Benefits Group Commercial |
$19.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.07
|
| Rate for Payer: Multiplan Commercial |
$26.37
|
| Rate for Payer: Networks By Design Commercial |
$21.42
|
| Rate for Payer: Prime Health Services Commercial |
$28.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.48
|
| Rate for Payer: United Healthcare All Other HMO |
$16.48
|
| Rate for Payer: United Healthcare HMO Rider |
$16.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.02
|
| Rate for Payer: Vantage Medical Group Senior |
$28.02
|
|
|
HC SUTURE MONOCRYL 6-0
|
Facility
|
OP
|
$66.83
|
|
| Hospital Charge Code |
901691016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$56.81 |
| Rate for Payer: Cigna of CA PPO |
$49.45
|
| Rate for Payer: Adventist Health Commercial |
$13.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$43.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$50.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.88
|
| Rate for Payer: Cash Price |
$30.07
|
| Rate for Payer: Cigna of CA HMO |
$42.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.73
|
| Rate for Payer: EPIC Health Plan Senior |
$26.73
|
| Rate for Payer: Galaxy Health WC |
$56.81
|
| Rate for Payer: Global Benefits Group Commercial |
$40.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.78
|
| Rate for Payer: Multiplan Commercial |
$53.46
|
| Rate for Payer: Networks By Design Commercial |
$43.44
|
| Rate for Payer: Prime Health Services Commercial |
$56.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.41
|
| Rate for Payer: United Healthcare All Other HMO |
$33.41
|
| Rate for Payer: United Healthcare HMO Rider |
$33.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.81
|
| Rate for Payer: Vantage Medical Group Senior |
$56.81
|
|
|
HC SUTURE MONOCRYL 6-0
|
Facility
|
IP
|
$66.83
|
|
| Hospital Charge Code |
901691016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$56.81 |
| Rate for Payer: Adventist Health Commercial |
$13.37
|
| Rate for Payer: Cash Price |
$30.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.73
|
| Rate for Payer: EPIC Health Plan Senior |
$26.73
|
| Rate for Payer: Galaxy Health WC |
$56.81
|
| Rate for Payer: Global Benefits Group Commercial |
$40.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.04
|
| Rate for Payer: Multiplan Commercial |
$53.46
|
| Rate for Payer: Networks By Design Commercial |
$43.44
|
| Rate for Payer: Prime Health Services Commercial |
$56.81
|
|
|
HC SUTURE MRSILN 5MM BP1 107254
|
Facility
|
OP
|
$218.75
|
|
| Hospital Charge Code |
901694649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.75 |
| Max. Negotiated Rate |
$185.94 |
| Rate for Payer: Adventist Health Commercial |
$43.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$143.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$185.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$120.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$164.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$140.37
|
| Rate for Payer: Cash Price |
$98.44
|
| Rate for Payer: Cigna of CA HMO |
$140.00
|
| Rate for Payer: Cigna of CA PPO |
$161.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$185.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$185.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$153.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.50
|
| Rate for Payer: EPIC Health Plan Senior |
$87.50
|
| Rate for Payer: Galaxy Health WC |
$185.94
|
| Rate for Payer: Global Benefits Group Commercial |
$131.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$79.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$129.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$153.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$153.12
|
| Rate for Payer: Multiplan Commercial |
$175.00
|
| Rate for Payer: Networks By Design Commercial |
$142.19
|
| Rate for Payer: Prime Health Services Commercial |
$185.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$131.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$131.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$109.38
|
| Rate for Payer: United Healthcare All Other HMO |
$109.38
|
| Rate for Payer: United Healthcare HMO Rider |
$109.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$109.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$185.94
|
| Rate for Payer: Vantage Medical Group Senior |
$185.94
|
|
|
HC SUTURE MRSILN 5MM BP1 107254
|
Facility
|
IP
|
$218.75
|
|
| Hospital Charge Code |
901694649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.75 |
| Max. Negotiated Rate |
$185.94 |
| Rate for Payer: Adventist Health Commercial |
$43.75
|
| Rate for Payer: Cash Price |
$98.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$153.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.50
|
| Rate for Payer: EPIC Health Plan Senior |
$87.50
|
| Rate for Payer: Galaxy Health WC |
$185.94
|
| Rate for Payer: Global Benefits Group Commercial |
$131.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$138.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$129.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.50
|
| Rate for Payer: Multiplan Commercial |
$175.00
|
| Rate for Payer: Networks By Design Commercial |
$142.19
|
| Rate for Payer: Prime Health Services Commercial |
$185.94
|
|
|
HC SUTURE MRSILN CTX RS22 2152
|
Facility
|
OP
|
$263.83
|
|
| Hospital Charge Code |
901693123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.77 |
| Max. Negotiated Rate |
$224.26 |
| Rate for Payer: Adventist Health Commercial |
$52.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$173.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$224.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$197.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$169.30
|
| Rate for Payer: Cash Price |
$118.72
|
| Rate for Payer: Cigna of CA HMO |
$168.85
|
| Rate for Payer: Cigna of CA PPO |
$195.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$224.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$224.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$184.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.53
|
| Rate for Payer: EPIC Health Plan Senior |
$105.53
|
| Rate for Payer: Galaxy Health WC |
$224.26
|
| Rate for Payer: Global Benefits Group Commercial |
$158.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$167.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$95.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$155.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.68
|
| Rate for Payer: Multiplan Commercial |
$211.06
|
| Rate for Payer: Networks By Design Commercial |
$171.49
|
| Rate for Payer: Prime Health Services Commercial |
$224.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$158.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$158.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.91
|
| Rate for Payer: United Healthcare All Other HMO |
$131.91
|
| Rate for Payer: United Healthcare HMO Rider |
$131.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$224.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.26
|
| Rate for Payer: Vantage Medical Group Senior |
$224.26
|
|
|
HC SUTURE MRSILN CTX RS22 2152
|
Facility
|
IP
|
$263.83
|
|
| Hospital Charge Code |
901693123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.77 |
| Max. Negotiated Rate |
$224.26 |
| Rate for Payer: Adventist Health Commercial |
$52.77
|
| Rate for Payer: Cash Price |
$118.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$184.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.53
|
| Rate for Payer: EPIC Health Plan Senior |
$105.53
|
| Rate for Payer: Galaxy Health WC |
$224.26
|
| Rate for Payer: Global Benefits Group Commercial |
$158.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$167.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$155.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$63.32
|
| Rate for Payer: Multiplan Commercial |
$211.06
|
| Rate for Payer: Networks By Design Commercial |
$171.49
|
| Rate for Payer: Prime Health Services Commercial |
$224.26
|
|
|
HC SUTURE PDS 0 CI-1 102829
|
Facility
|
OP
|
$27.31
|
|
| Hospital Charge Code |
901694651
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.46 |
| Max. Negotiated Rate |
$23.21 |
| Rate for Payer: Adventist Health Commercial |
$5.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.52
|
| Rate for Payer: Cash Price |
$12.29
|
| Rate for Payer: Cigna of CA HMO |
$17.48
|
| Rate for Payer: Cigna of CA PPO |
$20.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.92
|
| Rate for Payer: EPIC Health Plan Senior |
$10.92
|
| Rate for Payer: Galaxy Health WC |
$23.21
|
| Rate for Payer: Global Benefits Group Commercial |
$16.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.12
|
| Rate for Payer: Multiplan Commercial |
$21.85
|
| Rate for Payer: Networks By Design Commercial |
$17.75
|
| Rate for Payer: Prime Health Services Commercial |
$23.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.65
|
| Rate for Payer: United Healthcare All Other HMO |
$13.65
|
| Rate for Payer: United Healthcare HMO Rider |
$13.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.21
|
| Rate for Payer: Vantage Medical Group Senior |
$23.21
|
|
|
HC SUTURE PDS 0 CI-1 102829
|
Facility
|
IP
|
$27.31
|
|
| Hospital Charge Code |
901694651
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.46 |
| Max. Negotiated Rate |
$23.21 |
| Rate for Payer: Adventist Health Commercial |
$5.46
|
| Rate for Payer: Cash Price |
$12.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.92
|
| Rate for Payer: EPIC Health Plan Senior |
$10.92
|
| Rate for Payer: Galaxy Health WC |
$23.21
|
| Rate for Payer: Global Benefits Group Commercial |
$16.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.55
|
| Rate for Payer: Multiplan Commercial |
$21.85
|
| Rate for Payer: Networks By Design Commercial |
$17.75
|
| Rate for Payer: Prime Health Services Commercial |
$23.21
|
|
|
HC SUTURE PDS 2-0 CT-1 128263
|
Facility
|
OP
|
$25.75
|
|
| Hospital Charge Code |
901693111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$21.89 |
| Rate for Payer: Vantage Medical Group Senior |
$21.89
|
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.52
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Cigna of CA HMO |
$16.48
|
| Rate for Payer: Cigna of CA PPO |
$19.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.02
|
| Rate for Payer: Multiplan Commercial |
$20.60
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO |
$12.88
|
| Rate for Payer: United Healthcare HMO Rider |
$12.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.89
|
|
|
HC SUTURE PDS 2-0 CT-1 128263
|
Facility
|
IP
|
$25.75
|
|
| Hospital Charge Code |
901693111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$21.89 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.18
|
| Rate for Payer: Multiplan Commercial |
$20.60
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
|
|
HC SUTURE PDS II 5-0 18" P-3
|
Facility
|
OP
|
$63.47
|
|
| Hospital Charge Code |
901601970
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.69 |
| Max. Negotiated Rate |
$53.95 |
| Rate for Payer: Adventist Health Commercial |
$12.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$41.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$53.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.73
|
| Rate for Payer: Cash Price |
$28.56
|
| Rate for Payer: Cigna of CA HMO |
$40.62
|
| Rate for Payer: Cigna of CA PPO |
$46.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$53.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$53.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$53.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$44.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.39
|
| Rate for Payer: EPIC Health Plan Senior |
$25.39
|
| Rate for Payer: Galaxy Health WC |
$53.95
|
| Rate for Payer: Global Benefits Group Commercial |
$38.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$37.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.43
|
| Rate for Payer: Multiplan Commercial |
$50.78
|
| Rate for Payer: Networks By Design Commercial |
$41.26
|
| Rate for Payer: Prime Health Services Commercial |
$53.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.73
|
| Rate for Payer: United Healthcare All Other HMO |
$31.73
|
| Rate for Payer: United Healthcare HMO Rider |
$31.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$53.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$53.95
|
| Rate for Payer: Vantage Medical Group Senior |
$53.95
|
|
