|
HC SUTURE CHROMIC CT-2 100063
|
Facility
|
IP
|
$21.24
|
|
| Hospital Charge Code |
901694627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Adventist Health Commercial |
$4.25
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Central Health Plan Commercial |
$16.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Multiplan Commercial |
$15.93
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
|
|
HC SUTURE CHROMIC CT-2 100063
|
Facility
|
OP
|
$21.24
|
|
| Hospital Charge Code |
901694627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Adventist Health Commercial |
$4.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.36
|
| Rate for Payer: Blue Shield of California Commercial |
$13.47
|
| Rate for Payer: Blue Shield of California EPN |
$8.47
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Central Health Plan Commercial |
$16.99
|
| Rate for Payer: Cigna of CA HMO |
$13.59
|
| Rate for Payer: Cigna of CA PPO |
$15.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$14.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$13.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.87
|
| Rate for Payer: Multiplan Commercial |
$15.93
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
| Rate for Payer: Riverside University Health System MISP |
$8.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.62
|
| Rate for Payer: United Healthcare All Other HMO |
$10.62
|
| Rate for Payer: United Healthcare HMO Rider |
$10.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.05
|
| Rate for Payer: Vantage Medical Group Senior |
$18.05
|
|
|
HC SUTURE CHROMIC GUT 0 102839
|
Facility
|
OP
|
$29.36
|
|
| Hospital Charge Code |
901694631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$26.42 |
| Rate for Payer: Adventist Health Commercial |
$5.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.08
|
| Rate for Payer: Blue Shield of California Commercial |
$18.61
|
| Rate for Payer: Blue Shield of California EPN |
$11.71
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Central Health Plan Commercial |
$23.49
|
| Rate for Payer: Cigna of CA HMO |
$18.79
|
| Rate for Payer: Cigna of CA PPO |
$21.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Senior |
$11.74
|
| Rate for Payer: Galaxy Health WC |
$24.96
|
| Rate for Payer: Global Benefits Group Commercial |
$17.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.55
|
| Rate for Payer: Multiplan Commercial |
$22.02
|
| Rate for Payer: Networks By Design Commercial |
$19.08
|
| Rate for Payer: Prime Health Services Commercial |
$24.96
|
| Rate for Payer: Riverside University Health System MISP |
$11.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.68
|
| Rate for Payer: United Healthcare All Other HMO |
$14.68
|
| Rate for Payer: United Healthcare HMO Rider |
$14.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.96
|
| Rate for Payer: Vantage Medical Group Senior |
$24.96
|
|
|
HC SUTURE CHROMIC GUT 0 102839
|
Facility
|
IP
|
$29.36
|
|
| Hospital Charge Code |
901694631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$26.42 |
| Rate for Payer: Adventist Health Commercial |
$5.87
|
| Rate for Payer: Cash Price |
$13.21
|
| Rate for Payer: Central Health Plan Commercial |
$23.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Senior |
$11.74
|
| Rate for Payer: Galaxy Health WC |
$24.96
|
| Rate for Payer: Global Benefits Group Commercial |
$17.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.87
|
| Rate for Payer: Multiplan Commercial |
$22.02
|
| Rate for Payer: Networks By Design Commercial |
$19.08
|
| Rate for Payer: Prime Health Services Commercial |
$24.96
|
|
|
HC SUTURE CHROMIC GUT 0 113342
|
Facility
|
IP
|
$26.97
|
|
| Hospital Charge Code |
901694612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Adventist Health Commercial |
$5.39
|
| Rate for Payer: Cash Price |
$12.14
|
| Rate for Payer: Central Health Plan Commercial |
$21.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.79
|
| Rate for Payer: EPIC Health Plan Senior |
$10.79
|
| Rate for Payer: Galaxy Health WC |
$22.92
|
| Rate for Payer: Global Benefits Group Commercial |
$16.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$20.23
|
| Rate for Payer: Networks By Design Commercial |
$17.53
|
| Rate for Payer: Prime Health Services Commercial |
$22.92
|
|
|
HC SUTURE CHROMIC GUT 0 113342
|
Facility
|
OP
|
$26.97
|
|
| Hospital Charge Code |
901694612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Adventist Health Commercial |
$5.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.69
|
| Rate for Payer: Blue Shield of California Commercial |
$17.10
|
| Rate for Payer: Blue Shield of California EPN |
$10.76
|
| Rate for Payer: Cash Price |
$12.14
|
| Rate for Payer: Central Health Plan Commercial |
$21.58
|
| Rate for Payer: Cigna of CA HMO |
$17.26
|
| Rate for Payer: Cigna of CA PPO |
$19.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.79
|
| Rate for Payer: EPIC Health Plan Senior |
$10.79
|
| Rate for Payer: Galaxy Health WC |
$22.92
|
| Rate for Payer: Global Benefits Group Commercial |
$16.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.27
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.88
|
| Rate for Payer: Multiplan Commercial |
$20.23
|
| Rate for Payer: Networks By Design Commercial |
$17.53
|
| Rate for Payer: Prime Health Services Commercial |
$22.92
|
| Rate for Payer: Riverside University Health System MISP |
$10.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.48
|
| Rate for Payer: United Healthcare All Other HMO |
$13.48
|
| Rate for Payer: United Healthcare HMO Rider |
$13.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.92
|
| Rate for Payer: Vantage Medical Group Senior |
$22.92
|
|
|
HC SUTURE CHROMIC GUT 0 18"210353
|
Facility
|
OP
|
$179.06
|
|
| Hospital Charge Code |
901693102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$161.15 |
| Rate for Payer: Adventist Health Commercial |
$35.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$152.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$98.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$86.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.16
|
| Rate for Payer: Blue Shield of California Commercial |
$113.52
|
| Rate for Payer: Blue Shield of California EPN |
$71.44
|
| Rate for Payer: Cash Price |
$80.58
|
| Rate for Payer: Central Health Plan Commercial |
$143.25
|
| Rate for Payer: Cigna of CA HMO |
$114.60
|
| Rate for Payer: Cigna of CA PPO |
$132.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$152.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$152.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$152.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.62
|
| Rate for Payer: EPIC Health Plan Senior |
$71.62
|
| Rate for Payer: Galaxy Health WC |
$152.20
|
| Rate for Payer: Global Benefits Group Commercial |
$107.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$65.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$105.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$125.34
|
| Rate for Payer: Multiplan Commercial |
$134.29
|
| Rate for Payer: Networks By Design Commercial |
$116.39
|
| Rate for Payer: Prime Health Services Commercial |
$152.20
|
| Rate for Payer: Riverside University Health System MISP |
$71.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$89.53
|
| Rate for Payer: United Healthcare All Other HMO |
$89.53
|
| Rate for Payer: United Healthcare HMO Rider |
$89.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$89.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$152.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$152.20
|
| Rate for Payer: Vantage Medical Group Senior |
$152.20
|
|
|
HC SUTURE CHROMIC GUT 0 18"210353
|
Facility
|
IP
|
$179.06
|
|
| Hospital Charge Code |
901693102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$161.15 |
| Rate for Payer: Adventist Health Commercial |
$35.81
|
| Rate for Payer: Cash Price |
$80.58
|
| Rate for Payer: Central Health Plan Commercial |
$143.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$125.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.62
|
| Rate for Payer: EPIC Health Plan Senior |
$71.62
|
| Rate for Payer: Galaxy Health WC |
$152.20
|
| Rate for Payer: Global Benefits Group Commercial |
$107.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$113.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$105.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.81
|
| Rate for Payer: Multiplan Commercial |
$134.29
|
| Rate for Payer: Networks By Design Commercial |
$116.39
|
| Rate for Payer: Prime Health Services Commercial |
$152.20
|
|
|
HC SUTURE CHROMIC GUT 1-0 105493
|
Facility
|
IP
|
$32.55
|
|
| Hospital Charge Code |
901694864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$29.30 |
| Rate for Payer: Adventist Health Commercial |
$6.51
|
| Rate for Payer: Cash Price |
$14.65
|
| Rate for Payer: Central Health Plan Commercial |
$26.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.02
|
| Rate for Payer: EPIC Health Plan Senior |
$13.02
|
| Rate for Payer: Galaxy Health WC |
$27.67
|
| Rate for Payer: Global Benefits Group Commercial |
$19.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.51
|
| Rate for Payer: Multiplan Commercial |
$24.41
|
| Rate for Payer: Networks By Design Commercial |
$21.16
|
| Rate for Payer: Prime Health Services Commercial |
$27.67
|
|
|
HC SUTURE CHROMIC GUT 1-0 105493
|
Facility
|
OP
|
$32.55
|
|
| Hospital Charge Code |
901694864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.51 |
| Max. Negotiated Rate |
$29.30 |
| Rate for Payer: Adventist Health Commercial |
$6.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.93
|
| Rate for Payer: Blue Shield of California Commercial |
$20.64
|
| Rate for Payer: Blue Shield of California EPN |
$12.99
|
| Rate for Payer: Cash Price |
$14.65
|
| Rate for Payer: Central Health Plan Commercial |
$26.04
|
| Rate for Payer: Cigna of CA HMO |
$20.83
|
| Rate for Payer: Cigna of CA PPO |
$24.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.02
|
| Rate for Payer: EPIC Health Plan Senior |
$13.02
|
| Rate for Payer: Galaxy Health WC |
$27.67
|
| Rate for Payer: Global Benefits Group Commercial |
$19.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.79
|
| Rate for Payer: Multiplan Commercial |
$24.41
|
| Rate for Payer: Networks By Design Commercial |
$21.16
|
| Rate for Payer: Prime Health Services Commercial |
$27.67
|
| Rate for Payer: Riverside University Health System MISP |
$13.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.27
|
| Rate for Payer: United Healthcare All Other HMO |
$16.27
|
| Rate for Payer: United Healthcare HMO Rider |
$16.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.67
|
| Rate for Payer: Vantage Medical Group Senior |
$27.67
|
|
|
HC SUTURE CHROMIC GUT 1-0 105628
|
Facility
|
OP
|
$182.00
|
|
| Hospital Charge Code |
901694865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$110.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$154.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$100.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$136.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$88.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.87
|
| Rate for Payer: Blue Shield of California Commercial |
$115.39
|
| Rate for Payer: Blue Shield of California EPN |
$72.62
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Central Health Plan Commercial |
$145.60
|
| Rate for Payer: Cigna of CA HMO |
$116.48
|
| Rate for Payer: Cigna of CA PPO |
$134.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$154.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$154.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$154.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.80
|
| Rate for Payer: EPIC Health Plan Senior |
$72.80
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$163.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$66.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$107.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$127.40
|
| Rate for Payer: Multiplan Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
| Rate for Payer: Riverside University Health System MISP |
$72.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$109.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$109.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$91.00
|
| Rate for Payer: United Healthcare All Other HMO |
$91.00
|
| Rate for Payer: United Healthcare HMO Rider |
$91.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$154.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$154.70
|
| Rate for Payer: Vantage Medical Group Senior |
$154.70
|
|
|
HC SUTURE CHROMIC GUT 1-0 105628
|
Facility
|
IP
|
$182.00
|
|
| Hospital Charge Code |
901694865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$36.40 |
| Max. Negotiated Rate |
$163.80 |
| Rate for Payer: Adventist Health Commercial |
$36.40
|
| Rate for Payer: Cash Price |
$81.90
|
| Rate for Payer: Central Health Plan Commercial |
$145.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$127.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.80
|
| Rate for Payer: EPIC Health Plan Senior |
$72.80
|
| Rate for Payer: Galaxy Health WC |
$154.70
|
| Rate for Payer: Global Benefits Group Commercial |
$109.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$163.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$115.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$107.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.40
|
| Rate for Payer: Multiplan Commercial |
$136.50
|
| Rate for Payer: Networks By Design Commercial |
$118.30
|
| Rate for Payer: Prime Health Services Commercial |
$154.70
|
|
|
HC SUTURE CHROMIC GUT 2-0 G5-21
|
Facility
|
IP
|
$61.17
|
|
| Hospital Charge Code |
901698694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$55.05 |
| Rate for Payer: Adventist Health Commercial |
$12.23
|
| Rate for Payer: Cash Price |
$27.53
|
| Rate for Payer: Central Health Plan Commercial |
$48.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.47
|
| Rate for Payer: EPIC Health Plan Senior |
$24.47
|
| Rate for Payer: Galaxy Health WC |
$51.99
|
| Rate for Payer: Global Benefits Group Commercial |
$36.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.23
|
| Rate for Payer: Multiplan Commercial |
$45.88
|
| Rate for Payer: Networks By Design Commercial |
$39.76
|
| Rate for Payer: Prime Health Services Commercial |
$51.99
|
|
|
HC SUTURE CHROMIC GUT 2-0 G5-21
|
Facility
|
OP
|
$61.17
|
|
| Hospital Charge Code |
901698694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$55.05 |
| Rate for Payer: Adventist Health Commercial |
$12.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$37.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.58
|
| Rate for Payer: Blue Shield of California Commercial |
$38.78
|
| Rate for Payer: Blue Shield of California EPN |
$24.41
|
| Rate for Payer: Cash Price |
$27.53
|
| Rate for Payer: Central Health Plan Commercial |
$48.94
|
| Rate for Payer: Cigna of CA HMO |
$39.15
|
| Rate for Payer: Cigna of CA PPO |
$45.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.99
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.47
|
| Rate for Payer: EPIC Health Plan Senior |
$24.47
|
| Rate for Payer: Galaxy Health WC |
$51.99
|
| Rate for Payer: Global Benefits Group Commercial |
$36.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$42.82
|
| Rate for Payer: Multiplan Commercial |
$45.88
|
| Rate for Payer: Networks By Design Commercial |
$39.76
|
| Rate for Payer: Prime Health Services Commercial |
$51.99
|
| Rate for Payer: Riverside University Health System MISP |
$24.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.59
|
| Rate for Payer: United Healthcare All Other HMO |
$30.59
|
| Rate for Payer: United Healthcare HMO Rider |
$30.59
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.99
|
| Rate for Payer: Vantage Medical Group Senior |
$51.99
|
|
|
HC SUTURE CHROMIC GUT 4-0
|
Facility
|
OP
|
$32.88
|
|
| Hospital Charge Code |
901603479
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$29.59 |
| Rate for Payer: Adventist Health Commercial |
$6.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.13
|
| Rate for Payer: Blue Shield of California Commercial |
$20.85
|
| Rate for Payer: Blue Shield of California EPN |
$13.12
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Central Health Plan Commercial |
$26.30
|
| Rate for Payer: Cigna of CA HMO |
$21.04
|
| Rate for Payer: Cigna of CA PPO |
$24.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.15
|
| Rate for Payer: EPIC Health Plan Senior |
$13.15
|
| Rate for Payer: Galaxy Health WC |
$27.95
|
| Rate for Payer: Global Benefits Group Commercial |
$19.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$23.02
|
| Rate for Payer: Multiplan Commercial |
$24.66
|
| Rate for Payer: Networks By Design Commercial |
$21.37
|
| Rate for Payer: Prime Health Services Commercial |
$27.95
|
| Rate for Payer: Riverside University Health System MISP |
$13.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.44
|
| Rate for Payer: United Healthcare All Other HMO |
$16.44
|
| Rate for Payer: United Healthcare HMO Rider |
$16.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.95
|
| Rate for Payer: Vantage Medical Group Senior |
$27.95
|
|
|
HC SUTURE CHROMIC GUT 4-0
|
Facility
|
IP
|
$32.88
|
|
| Hospital Charge Code |
901603479
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.58 |
| Max. Negotiated Rate |
$29.59 |
| Rate for Payer: Adventist Health Commercial |
$6.58
|
| Rate for Payer: Cash Price |
$14.80
|
| Rate for Payer: Central Health Plan Commercial |
$26.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.15
|
| Rate for Payer: EPIC Health Plan Senior |
$13.15
|
| Rate for Payer: Galaxy Health WC |
$27.95
|
| Rate for Payer: Global Benefits Group Commercial |
$19.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.58
|
| Rate for Payer: Multiplan Commercial |
$24.66
|
| Rate for Payer: Networks By Design Commercial |
$21.37
|
| Rate for Payer: Prime Health Services Commercial |
$27.95
|
|
|
HC SUTURE CHROMIC GUT 4-0 27"
|
Facility
|
OP
|
$29.93
|
|
| Hospital Charge Code |
901601293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$26.94 |
| Rate for Payer: Adventist Health Commercial |
$5.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.41
|
| Rate for Payer: Blue Shield of California Commercial |
$18.98
|
| Rate for Payer: Blue Shield of California EPN |
$11.94
|
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Central Health Plan Commercial |
$23.94
|
| Rate for Payer: Cigna of CA HMO |
$19.16
|
| Rate for Payer: Cigna of CA PPO |
$22.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: EPIC Health Plan Senior |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.95
|
| Rate for Payer: Multiplan Commercial |
$22.45
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
| Rate for Payer: Riverside University Health System MISP |
$11.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.96
|
| Rate for Payer: United Healthcare All Other HMO |
$14.96
|
| Rate for Payer: United Healthcare HMO Rider |
$14.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.44
|
| Rate for Payer: Vantage Medical Group Senior |
$25.44
|
|
|
HC SUTURE CHROMIC GUT 4-0 27"
|
Facility
|
IP
|
$29.93
|
|
| Hospital Charge Code |
901601293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$26.94 |
| Rate for Payer: Adventist Health Commercial |
$5.99
|
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Central Health Plan Commercial |
$23.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: EPIC Health Plan Senior |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.99
|
| Rate for Payer: Multiplan Commercial |
$22.45
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
|
|
HC SUTURE CHROMIC GUT 5-0 18"
|
Facility
|
OP
|
$39.61
|
|
| Hospital Charge Code |
901604111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$35.65 |
| Rate for Payer: Adventist Health Commercial |
$7.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.71
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.04
|
| Rate for Payer: Blue Shield of California Commercial |
$25.11
|
| Rate for Payer: Blue Shield of California EPN |
$15.80
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Central Health Plan Commercial |
$31.69
|
| Rate for Payer: Cigna of CA HMO |
$25.35
|
| Rate for Payer: Cigna of CA PPO |
$29.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.84
|
| Rate for Payer: EPIC Health Plan Senior |
$15.84
|
| Rate for Payer: Galaxy Health WC |
$33.67
|
| Rate for Payer: Global Benefits Group Commercial |
$23.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.73
|
| Rate for Payer: Multiplan Commercial |
$29.71
|
| Rate for Payer: Networks By Design Commercial |
$25.75
|
| Rate for Payer: Prime Health Services Commercial |
$33.67
|
| Rate for Payer: Riverside University Health System MISP |
$15.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.77
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.80
|
| Rate for Payer: United Healthcare All Other HMO |
$19.80
|
| Rate for Payer: United Healthcare HMO Rider |
$19.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.67
|
| Rate for Payer: Vantage Medical Group Senior |
$33.67
|
|
|
HC SUTURE CHROMIC GUT 5-0 18"
|
Facility
|
IP
|
$39.61
|
|
| Hospital Charge Code |
901604111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$35.65 |
| Rate for Payer: Adventist Health Commercial |
$7.92
|
| Rate for Payer: Cash Price |
$17.82
|
| Rate for Payer: Central Health Plan Commercial |
$31.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.84
|
| Rate for Payer: EPIC Health Plan Senior |
$15.84
|
| Rate for Payer: Galaxy Health WC |
$33.67
|
| Rate for Payer: Global Benefits Group Commercial |
$23.77
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.65
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$25.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.92
|
| Rate for Payer: Multiplan Commercial |
$29.71
|
| Rate for Payer: Networks By Design Commercial |
$25.75
|
| Rate for Payer: Prime Health Services Commercial |
$33.67
|
|
|
HC SUTURE CHROMIC GUT 6-0 18"
|
Facility
|
IP
|
$172.83
|
|
| Hospital Charge Code |
901601295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.57 |
| Max. Negotiated Rate |
$155.55 |
| Rate for Payer: Adventist Health Commercial |
$34.57
|
| Rate for Payer: Cash Price |
$77.77
|
| Rate for Payer: Central Health Plan Commercial |
$138.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$120.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.13
|
| Rate for Payer: EPIC Health Plan Senior |
$69.13
|
| Rate for Payer: Galaxy Health WC |
$146.91
|
| Rate for Payer: Global Benefits Group Commercial |
$103.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$155.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$109.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$101.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.57
|
| Rate for Payer: Multiplan Commercial |
$129.62
|
| Rate for Payer: Networks By Design Commercial |
$112.34
|
| Rate for Payer: Prime Health Services Commercial |
$146.91
|
|
|
HC SUTURE CHROMIC GUT 6-0 18"
|
Facility
|
OP
|
$172.83
|
|
| Hospital Charge Code |
901601295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$34.57 |
| Max. Negotiated Rate |
$155.55 |
| Rate for Payer: Adventist Health Commercial |
$34.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$104.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$146.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$95.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$129.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$83.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$100.54
|
| Rate for Payer: Blue Shield of California Commercial |
$109.57
|
| Rate for Payer: Blue Shield of California EPN |
$68.96
|
| Rate for Payer: Cash Price |
$77.77
|
| Rate for Payer: Central Health Plan Commercial |
$138.26
|
| Rate for Payer: Cigna of CA HMO |
$110.61
|
| Rate for Payer: Cigna of CA PPO |
$127.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$146.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$146.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$146.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$120.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$69.13
|
| Rate for Payer: EPIC Health Plan Senior |
$69.13
|
| Rate for Payer: Galaxy Health WC |
$146.91
|
| Rate for Payer: Global Benefits Group Commercial |
$103.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$155.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$109.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$62.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$101.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$34.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$120.98
|
| Rate for Payer: Multiplan Commercial |
$129.62
|
| Rate for Payer: Networks By Design Commercial |
$112.34
|
| Rate for Payer: Prime Health Services Commercial |
$146.91
|
| Rate for Payer: Riverside University Health System MISP |
$69.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$103.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$103.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$86.42
|
| Rate for Payer: United Healthcare All Other HMO |
$86.42
|
| Rate for Payer: United Healthcare HMO Rider |
$86.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$86.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$146.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$146.91
|
| Rate for Payer: Vantage Medical Group Senior |
$146.91
|
|
|
HC SUTURE CHROMIC GUT SZ1 135721
|
Facility
|
IP
|
$37.15
|
|
| Hospital Charge Code |
901694626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.43 |
| Max. Negotiated Rate |
$33.44 |
| Rate for Payer: Adventist Health Commercial |
$7.43
|
| Rate for Payer: Cash Price |
$16.72
|
| Rate for Payer: Central Health Plan Commercial |
$29.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.86
|
| Rate for Payer: EPIC Health Plan Senior |
$14.86
|
| Rate for Payer: Galaxy Health WC |
$31.58
|
| Rate for Payer: Global Benefits Group Commercial |
$22.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.43
|
| Rate for Payer: Multiplan Commercial |
$27.86
|
| Rate for Payer: Networks By Design Commercial |
$24.15
|
| Rate for Payer: Prime Health Services Commercial |
$31.58
|
|
|
HC SUTURE CHROMIC GUT SZ1 135721
|
Facility
|
OP
|
$37.15
|
|
| Hospital Charge Code |
901694626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.43 |
| Max. Negotiated Rate |
$33.44 |
| Rate for Payer: Adventist Health Commercial |
$7.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.61
|
| Rate for Payer: Blue Shield of California Commercial |
$23.55
|
| Rate for Payer: Blue Shield of California EPN |
$14.82
|
| Rate for Payer: Cash Price |
$16.72
|
| Rate for Payer: Central Health Plan Commercial |
$29.72
|
| Rate for Payer: Cigna of CA HMO |
$23.78
|
| Rate for Payer: Cigna of CA PPO |
$27.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.86
|
| Rate for Payer: EPIC Health Plan Senior |
$14.86
|
| Rate for Payer: Galaxy Health WC |
$31.58
|
| Rate for Payer: Global Benefits Group Commercial |
$22.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.00
|
| Rate for Payer: Multiplan Commercial |
$27.86
|
| Rate for Payer: Networks By Design Commercial |
$24.15
|
| Rate for Payer: Prime Health Services Commercial |
$31.58
|
| Rate for Payer: Riverside University Health System MISP |
$14.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.57
|
| Rate for Payer: United Healthcare All Other HMO |
$18.57
|
| Rate for Payer: United Healthcare HMO Rider |
$18.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.58
|
| Rate for Payer: Vantage Medical Group Senior |
$31.58
|
|
|
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 |
$92.07 |
| Rate for Payer: Adventist Health Commercial |
$20.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.13
|
| 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 Exchange |
$49.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$59.51
|
| Rate for Payer: Blue Shield of California Commercial |
$64.86
|
| Rate for Payer: Blue Shield of California EPN |
$40.82
|
| Rate for Payer: Cash Price |
$46.04
|
| Rate for Payer: Central Health Plan Commercial |
$81.84
|
| 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: Health Management Network EPO/PPO |
$92.07
|
| 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 |
$20.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$71.61
|
| Rate for Payer: Multiplan Commercial |
$76.72
|
| Rate for Payer: Networks By Design Commercial |
$66.50
|
| Rate for Payer: Prime Health Services Commercial |
$86.95
|
| Rate for Payer: Riverside University Health System MISP |
$40.92
|
| 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
|
|
