|
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 |
$92.07 |
| Rate for Payer: Adventist Health Commercial |
$20.46
|
| Rate for Payer: Cash Price |
$46.04
|
| Rate for Payer: Central Health Plan Commercial |
$81.84
|
| 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 Medicare Advantage |
$60.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.46
|
| 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
|
|
|
HC SUTURE DERMALON 3-0 18" C-14
|
Facility
|
OP
|
$79.54
|
|
| Hospital Charge Code |
901601298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$71.59 |
| Rate for Payer: Adventist Health Commercial |
$15.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$48.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$67.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$43.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$59.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$38.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$46.27
|
| Rate for Payer: Blue Shield of California Commercial |
$50.43
|
| Rate for Payer: Blue Shield of California EPN |
$31.74
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Central Health Plan Commercial |
$63.63
|
| Rate for Payer: Cigna of CA HMO |
$50.91
|
| Rate for Payer: Cigna of CA PPO |
$58.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$67.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$67.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$67.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$55.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.82
|
| Rate for Payer: EPIC Health Plan Senior |
$31.82
|
| Rate for Payer: Galaxy Health WC |
$67.61
|
| Rate for Payer: Global Benefits Group Commercial |
$47.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$71.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$50.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$28.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$55.68
|
| Rate for Payer: Multiplan Commercial |
$59.66
|
| Rate for Payer: Networks By Design Commercial |
$51.70
|
| Rate for Payer: Prime Health Services Commercial |
$67.61
|
| Rate for Payer: Riverside University Health System MISP |
$31.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$47.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$47.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$39.77
|
| Rate for Payer: United Healthcare All Other HMO |
$39.77
|
| Rate for Payer: United Healthcare HMO Rider |
$39.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$67.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$67.61
|
| Rate for Payer: Vantage Medical Group Senior |
$67.61
|
|
|
HC SUTURE DERMALON 3-0 18" C-14
|
Facility
|
IP
|
$79.54
|
|
| Hospital Charge Code |
901601298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$15.91 |
| Max. Negotiated Rate |
$71.59 |
| Rate for Payer: Adventist Health Commercial |
$15.91
|
| Rate for Payer: Cash Price |
$35.79
|
| Rate for Payer: Central Health Plan Commercial |
$63.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$55.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$31.82
|
| Rate for Payer: EPIC Health Plan Senior |
$31.82
|
| Rate for Payer: Galaxy Health WC |
$67.61
|
| Rate for Payer: Global Benefits Group Commercial |
$47.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$71.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$50.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$46.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$15.91
|
| Rate for Payer: Multiplan Commercial |
$59.66
|
| Rate for Payer: Networks By Design Commercial |
$51.70
|
| Rate for Payer: Prime Health Services Commercial |
$67.61
|
|
|
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 |
$18.59 |
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Central Health Plan Commercial |
$16.53
|
| 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: Health Management Network EPO/PPO |
$18.59
|
| 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 |
$4.13
|
| Rate for Payer: Multiplan Commercial |
$15.49
|
| 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 |
$18.59 |
| Rate for Payer: Adventist Health Commercial |
$4.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.55
|
| 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 Exchange |
$10.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.02
|
| Rate for Payer: Blue Shield of California Commercial |
$13.10
|
| Rate for Payer: Blue Shield of California EPN |
$8.24
|
| Rate for Payer: Cash Price |
$9.30
|
| Rate for Payer: Central Health Plan Commercial |
$16.53
|
| Rate for Payer: Cigna of CA HMO |
$13.22
|
| Rate for Payer: Cigna of CA PPO |
$15.29
|
| 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: Health Management Network EPO/PPO |
$18.59
|
| 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 |
$4.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14.46
|
| Rate for Payer: Multiplan Commercial |
$15.49
|
| Rate for Payer: Networks By Design Commercial |
$13.43
|
| Rate for Payer: Prime Health Services Commercial |
$17.56
|
| Rate for Payer: Riverside University Health System MISP |
$8.26
|
| 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
|
IP
|
$45.84
|
|
| Hospital Charge Code |
901604016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.17 |
| Max. Negotiated Rate |
$41.26 |
| Rate for Payer: Adventist Health Commercial |
$9.17
|
| Rate for Payer: Cash Price |
$20.63
|
| Rate for Payer: Central Health Plan Commercial |
$36.67
|
| 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: Health Management Network EPO/PPO |
$41.26
|
| 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 |
$9.17
|
| Rate for Payer: Multiplan Commercial |
$34.38
|
| Rate for Payer: Networks By Design Commercial |
$29.80
|
| Rate for Payer: Prime Health Services Commercial |
$38.96
|
|
|
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 |
$41.26 |
| Rate for Payer: Adventist Health Commercial |
$9.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.84
|
| 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 Exchange |
$22.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.67
|
| Rate for Payer: Blue Shield of California Commercial |
$29.06
|
| Rate for Payer: Blue Shield of California EPN |
$18.29
|
| Rate for Payer: Cash Price |
$20.63
|
| Rate for Payer: Central Health Plan Commercial |
$36.67
|
| 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: Health Management Network EPO/PPO |
$41.26
|
| 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 |
$9.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$32.09
|
| Rate for Payer: Multiplan Commercial |
$34.38
|
| Rate for Payer: Networks By Design Commercial |
$29.80
|
| Rate for Payer: Prime Health Services Commercial |
$38.96
|
| Rate for Payer: Riverside University Health System MISP |
$18.34
|
| 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 4-0 18"
|
Facility
|
IP
|
$41.98
|
|
| Hospital Charge Code |
901603481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.40 |
| Max. Negotiated Rate |
$37.78 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Cash Price |
$18.89
|
| Rate for Payer: Central Health Plan Commercial |
$33.58
|
| 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: Health Management Network EPO/PPO |
$37.78
|
| 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 |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$31.48
|
| 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 |
$37.78 |
| Rate for Payer: Adventist Health Commercial |
$8.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.49
|
| 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 Exchange |
$20.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.42
|
| Rate for Payer: Blue Shield of California Commercial |
$26.62
|
| Rate for Payer: Blue Shield of California EPN |
$16.75
|
| Rate for Payer: Cash Price |
$18.89
|
| Rate for Payer: Central Health Plan Commercial |
$33.58
|
| 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: Health Management Network EPO/PPO |
$37.78
|
| 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 |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29.39
|
| Rate for Payer: Multiplan Commercial |
$31.48
|
| Rate for Payer: Networks By Design Commercial |
$27.29
|
| Rate for Payer: Prime Health Services Commercial |
$35.68
|
| Rate for Payer: Riverside University Health System MISP |
$16.79
|
| 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
|
OP
|
$42.23
|
|
| Hospital Charge Code |
901603977
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$38.01 |
| Rate for Payer: Adventist Health Commercial |
$8.45
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.65
|
| 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 Exchange |
$20.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.57
|
| Rate for Payer: Blue Shield of California Commercial |
$26.77
|
| Rate for Payer: Blue Shield of California EPN |
$16.85
|
| Rate for Payer: Cash Price |
$19.00
|
| Rate for Payer: Central Health Plan Commercial |
$33.78
|
| 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: Health Management Network EPO/PPO |
$38.01
|
| 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 |
$8.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29.56
|
| Rate for Payer: Multiplan Commercial |
$31.67
|
| Rate for Payer: Networks By Design Commercial |
$27.45
|
| Rate for Payer: Prime Health Services Commercial |
$35.90
|
| Rate for Payer: Riverside University Health System MISP |
$16.89
|
| 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" P-3
|
Facility
|
IP
|
$42.23
|
|
| Hospital Charge Code |
901603977
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.45 |
| Max. Negotiated Rate |
$38.01 |
| Rate for Payer: Adventist Health Commercial |
$8.45
|
| Rate for Payer: Cash Price |
$19.00
|
| Rate for Payer: Central Health Plan Commercial |
$33.78
|
| 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: Health Management Network EPO/PPO |
$38.01
|
| 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 |
$8.45
|
| Rate for Payer: Multiplan Commercial |
$31.67
|
| Rate for Payer: Networks By Design Commercial |
$27.45
|
| Rate for Payer: Prime Health Services Commercial |
$35.90
|
|
|
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 |
$39.34 |
| Rate for Payer: Adventist Health Commercial |
$8.74
|
| Rate for Payer: Cash Price |
$19.67
|
| Rate for Payer: Central Health Plan Commercial |
$34.97
|
| 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: Health Management Network EPO/PPO |
$39.34
|
| 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 |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$32.78
|
| 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-1
|
Facility
|
OP
|
$43.71
|
|
| Hospital Charge Code |
901601299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.74 |
| Max. Negotiated Rate |
$39.34 |
| Rate for Payer: Adventist Health Commercial |
$8.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.55
|
| 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 Exchange |
$21.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.43
|
| Rate for Payer: Blue Shield of California Commercial |
$27.71
|
| Rate for Payer: Blue Shield of California EPN |
$17.44
|
| Rate for Payer: Cash Price |
$19.67
|
| Rate for Payer: Central Health Plan Commercial |
$34.97
|
| 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: Health Management Network EPO/PPO |
$39.34
|
| 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 |
$8.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$30.60
|
| Rate for Payer: Multiplan Commercial |
$32.78
|
| Rate for Payer: Networks By Design Commercial |
$28.41
|
| Rate for Payer: Prime Health Services Commercial |
$37.15
|
| Rate for Payer: Riverside University Health System MISP |
$17.48
|
| 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-5
|
Facility
|
OP
|
$29.77
|
|
| Hospital Charge Code |
901604015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$26.79 |
| Rate for Payer: Adventist Health Commercial |
$5.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.32
|
| Rate for Payer: Blue Shield of California Commercial |
$18.87
|
| Rate for Payer: Blue Shield of California EPN |
$11.88
|
| Rate for Payer: Cash Price |
$13.40
|
| Rate for Payer: Central Health Plan Commercial |
$23.82
|
| Rate for Payer: Cigna of CA HMO |
$19.05
|
| Rate for Payer: Cigna of CA PPO |
$22.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.91
|
| Rate for Payer: EPIC Health Plan Senior |
$11.91
|
| Rate for Payer: Galaxy Health WC |
$25.30
|
| Rate for Payer: Global Benefits Group Commercial |
$17.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.84
|
| Rate for Payer: Multiplan Commercial |
$22.33
|
| Rate for Payer: Networks By Design Commercial |
$19.35
|
| Rate for Payer: Prime Health Services Commercial |
$25.30
|
| Rate for Payer: Riverside University Health System MISP |
$11.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.88
|
| Rate for Payer: United Healthcare All Other HMO |
$14.88
|
| Rate for Payer: United Healthcare HMO Rider |
$14.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.30
|
| Rate for Payer: Vantage Medical Group Senior |
$25.30
|
|
|
HC SUTURE ETHILON 4-0 18" PC-5
|
Facility
|
IP
|
$29.77
|
|
| Hospital Charge Code |
901604015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$26.79 |
| Rate for Payer: Adventist Health Commercial |
$5.95
|
| Rate for Payer: Cash Price |
$13.40
|
| Rate for Payer: Central Health Plan Commercial |
$23.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.91
|
| Rate for Payer: EPIC Health Plan Senior |
$11.91
|
| Rate for Payer: Galaxy Health WC |
$25.30
|
| Rate for Payer: Global Benefits Group Commercial |
$17.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.95
|
| Rate for Payer: Multiplan Commercial |
$22.33
|
| Rate for Payer: Networks By Design Commercial |
$19.35
|
| Rate for Payer: Prime Health Services Commercial |
$25.30
|
|
|
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 |
$35.79 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.15
|
| 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 Exchange |
$19.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.13
|
| Rate for Payer: Blue Shield of California Commercial |
$25.21
|
| Rate for Payer: Blue Shield of California EPN |
$15.87
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Central Health Plan Commercial |
$31.82
|
| 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: Health Management Network EPO/PPO |
$35.79
|
| 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 |
$7.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.84
|
| Rate for Payer: Multiplan Commercial |
$29.83
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
| Rate for Payer: Riverside University Health System MISP |
$15.91
|
| 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 |
$35.79 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Central Health Plan Commercial |
$31.82
|
| 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: Health Management Network EPO/PPO |
$35.79
|
| 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 |
$7.95
|
| Rate for Payer: Multiplan Commercial |
$29.83
|
| 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
|
IP
|
$39.77
|
|
| Hospital Charge Code |
901600387
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.95 |
| Max. Negotiated Rate |
$35.79 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Central Health Plan Commercial |
$31.82
|
| 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: Health Management Network EPO/PPO |
$35.79
|
| 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 |
$7.95
|
| Rate for Payer: Multiplan Commercial |
$29.83
|
| 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 |
$35.79 |
| Rate for Payer: Adventist Health Commercial |
$7.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.15
|
| 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 Exchange |
$19.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.13
|
| Rate for Payer: Blue Shield of California Commercial |
$25.21
|
| Rate for Payer: Blue Shield of California EPN |
$15.87
|
| Rate for Payer: Cash Price |
$17.90
|
| Rate for Payer: Central Health Plan Commercial |
$31.82
|
| 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: Health Management Network EPO/PPO |
$35.79
|
| 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 |
$7.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.84
|
| Rate for Payer: Multiplan Commercial |
$29.83
|
| Rate for Payer: Networks By Design Commercial |
$25.85
|
| Rate for Payer: Prime Health Services Commercial |
$33.80
|
| Rate for Payer: Riverside University Health System MISP |
$15.91
|
| 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" P3
|
Facility
|
IP
|
$44.12
|
|
| Hospital Charge Code |
901604014
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.82 |
| Max. Negotiated Rate |
$39.71 |
| Rate for Payer: Adventist Health Commercial |
$8.82
|
| Rate for Payer: Cash Price |
$19.85
|
| Rate for Payer: Central Health Plan Commercial |
$35.30
|
| 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: Health Management Network EPO/PPO |
$39.71
|
| 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 |
$8.82
|
| Rate for Payer: Multiplan Commercial |
$33.09
|
| 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 |
$39.71 |
| Rate for Payer: Adventist Health Commercial |
$8.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.79
|
| 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 Exchange |
$21.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.66
|
| Rate for Payer: Blue Shield of California Commercial |
$27.97
|
| Rate for Payer: Blue Shield of California EPN |
$17.60
|
| Rate for Payer: Cash Price |
$19.85
|
| Rate for Payer: Central Health Plan Commercial |
$35.30
|
| 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: Health Management Network EPO/PPO |
$39.71
|
| 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 |
$8.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$30.88
|
| Rate for Payer: Multiplan Commercial |
$33.09
|
| Rate for Payer: Networks By Design Commercial |
$28.68
|
| Rate for Payer: Prime Health Services Commercial |
$37.50
|
| Rate for Payer: Riverside University Health System MISP |
$17.65
|
| 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
|
| Rate for Payer: Vantage Medical Group Senior |
$37.50
|
|
|
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 |
$36.16 |
| Rate for Payer: Adventist Health Commercial |
$8.04
|
| Rate for Payer: Cash Price |
$18.08
|
| Rate for Payer: Central Health Plan Commercial |
$32.14
|
| 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: Health Management Network EPO/PPO |
$36.16
|
| 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 |
$8.04
|
| Rate for Payer: Multiplan Commercial |
$30.14
|
| Rate for Payer: Networks By Design Commercial |
$26.12
|
| Rate for Payer: Prime Health Services Commercial |
$34.15
|
|
|
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 |
$36.16 |
| Rate for Payer: Adventist Health Commercial |
$8.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.40
|
| 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 Exchange |
$19.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.37
|
| Rate for Payer: Blue Shield of California Commercial |
$25.47
|
| Rate for Payer: Blue Shield of California EPN |
$16.03
|
| Rate for Payer: Cash Price |
$18.08
|
| Rate for Payer: Central Health Plan Commercial |
$32.14
|
| 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: Health Management Network EPO/PPO |
$36.16
|
| 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 |
$8.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28.13
|
| Rate for Payer: Multiplan Commercial |
$30.14
|
| Rate for Payer: Networks By Design Commercial |
$26.12
|
| Rate for Payer: Prime Health Services Commercial |
$34.15
|
| Rate for Payer: Riverside University Health System MISP |
$16.07
|
| 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 P-3
|
Facility
|
IP
|
$27.59
|
|
| Hospital Charge Code |
901691500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$24.83 |
| Rate for Payer: Adventist Health Commercial |
$5.52
|
| Rate for Payer: Cash Price |
$12.42
|
| Rate for Payer: Central Health Plan Commercial |
$22.07
|
| 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: Health Management Network EPO/PPO |
$24.83
|
| 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 |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$20.69
|
| Rate for Payer: Networks By Design Commercial |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$23.45
|
|
|
HC SUTURE ETHILON 5-0 P-3
|
Facility
|
OP
|
$27.59
|
|
| Hospital Charge Code |
901691500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$24.83 |
| Rate for Payer: Adventist Health Commercial |
$5.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.05
|
| Rate for Payer: Blue Shield of California Commercial |
$17.49
|
| Rate for Payer: Blue Shield of California EPN |
$11.01
|
| Rate for Payer: Cash Price |
$12.42
|
| Rate for Payer: Central Health Plan Commercial |
$22.07
|
| Rate for Payer: Cigna of CA HMO |
$17.66
|
| Rate for Payer: Cigna of CA PPO |
$20.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.45
|
| 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: Health Management Network EPO/PPO |
$24.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19.31
|
| Rate for Payer: Multiplan Commercial |
$20.69
|
| Rate for Payer: Networks By Design Commercial |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$23.45
|
| Rate for Payer: Riverside University Health System MISP |
$11.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.79
|
| Rate for Payer: United Healthcare All Other HMO |
$13.79
|
| Rate for Payer: United Healthcare HMO Rider |
$13.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.45
|
| Rate for Payer: Vantage Medical Group Senior |
$23.45
|
|
