|
HC SUTURE PDS II CTX 0 132691
|
Facility
|
OP
|
$60.68
|
|
| Hospital Charge Code |
901694652
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$54.61 |
| Rate for Payer: Adventist Health Commercial |
$12.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.30
|
| Rate for Payer: Blue Shield of California Commercial |
$38.47
|
| Rate for Payer: Blue Shield of California EPN |
$24.21
|
| Rate for Payer: Cash Price |
$27.31
|
| Rate for Payer: Central Health Plan Commercial |
$48.54
|
| Rate for Payer: Cigna of CA HMO |
$38.84
|
| Rate for Payer: Cigna of CA PPO |
$44.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.27
|
| Rate for Payer: EPIC Health Plan Senior |
$24.27
|
| Rate for Payer: Galaxy Health WC |
$51.58
|
| Rate for Payer: Global Benefits Group Commercial |
$36.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$22.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$42.48
|
| Rate for Payer: Multiplan Commercial |
$45.51
|
| Rate for Payer: Networks By Design Commercial |
$39.44
|
| Rate for Payer: Prime Health Services Commercial |
$51.58
|
| Rate for Payer: Riverside University Health System MISP |
$24.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.34
|
| Rate for Payer: United Healthcare All Other HMO |
$30.34
|
| Rate for Payer: United Healthcare HMO Rider |
$30.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.58
|
| Rate for Payer: Vantage Medical Group Senior |
$51.58
|
|
|
HC SUTURE PDS II CTX 0 132691
|
Facility
|
IP
|
$60.68
|
|
| Hospital Charge Code |
901694652
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$54.61 |
| Rate for Payer: Adventist Health Commercial |
$12.14
|
| Rate for Payer: Cash Price |
$27.31
|
| Rate for Payer: Central Health Plan Commercial |
$48.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.27
|
| Rate for Payer: EPIC Health Plan Senior |
$24.27
|
| Rate for Payer: Galaxy Health WC |
$51.58
|
| Rate for Payer: Global Benefits Group Commercial |
$36.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.14
|
| Rate for Payer: Multiplan Commercial |
$45.51
|
| Rate for Payer: Networks By Design Commercial |
$39.44
|
| Rate for Payer: Prime Health Services Commercial |
$51.58
|
|
|
HC SUTURE PERMA-HAND 3-0 18" FS-1
|
Facility
|
OP
|
$12.38
|
|
| Hospital Charge Code |
901698192
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$11.14 |
| Rate for Payer: Adventist Health Commercial |
$2.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$7.85
|
| Rate for Payer: Blue Shield of California EPN |
$4.94
|
| Rate for Payer: Cash Price |
$5.57
|
| Rate for Payer: Central Health Plan Commercial |
$9.90
|
| Rate for Payer: Cigna of CA HMO |
$7.92
|
| Rate for Payer: Cigna of CA PPO |
$9.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.95
|
| Rate for Payer: EPIC Health Plan Senior |
$4.95
|
| Rate for Payer: Galaxy Health WC |
$10.52
|
| Rate for Payer: Global Benefits Group Commercial |
$7.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$9.29
|
| Rate for Payer: Networks By Design Commercial |
$8.05
|
| Rate for Payer: Prime Health Services Commercial |
$10.52
|
| Rate for Payer: Riverside University Health System MISP |
$4.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.19
|
| Rate for Payer: United Healthcare All Other HMO |
$6.19
|
| Rate for Payer: United Healthcare HMO Rider |
$6.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.52
|
| Rate for Payer: Vantage Medical Group Senior |
$10.52
|
|
|
HC SUTURE PERMA-HAND 3-0 18" FS-1
|
Facility
|
IP
|
$12.38
|
|
| Hospital Charge Code |
901698192
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$11.14 |
| Rate for Payer: Adventist Health Commercial |
$2.48
|
| Rate for Payer: Cash Price |
$5.57
|
| Rate for Payer: Central Health Plan Commercial |
$9.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.95
|
| Rate for Payer: EPIC Health Plan Senior |
$4.95
|
| Rate for Payer: Galaxy Health WC |
$10.52
|
| Rate for Payer: Global Benefits Group Commercial |
$7.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.48
|
| Rate for Payer: Multiplan Commercial |
$9.29
|
| Rate for Payer: Networks By Design Commercial |
$8.05
|
| Rate for Payer: Prime Health Services Commercial |
$10.52
|
|
|
HC SUTURE PLAIN 0 54" LIGA TIES
|
Facility
|
IP
|
$37.15
|
|
| Hospital Charge Code |
901694609
|
|
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 PLAIN 0 54" LIGA TIES
|
Facility
|
OP
|
$37.15
|
|
| Hospital Charge Code |
901694609
|
|
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 PLAIN 3-0 102832
|
Facility
|
OP
|
$35.26
|
|
| Hospital Charge Code |
901694611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$31.73 |
| Rate for Payer: Adventist Health Commercial |
$7.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.51
|
| Rate for Payer: Blue Shield of California Commercial |
$22.35
|
| Rate for Payer: Blue Shield of California EPN |
$14.07
|
| Rate for Payer: Cash Price |
$15.87
|
| Rate for Payer: Central Health Plan Commercial |
$28.21
|
| Rate for Payer: Cigna of CA HMO |
$22.57
|
| Rate for Payer: Cigna of CA PPO |
$26.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.10
|
| Rate for Payer: EPIC Health Plan Senior |
$14.10
|
| Rate for Payer: Galaxy Health WC |
$29.97
|
| Rate for Payer: Global Benefits Group Commercial |
$21.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$24.68
|
| Rate for Payer: Multiplan Commercial |
$26.45
|
| Rate for Payer: Networks By Design Commercial |
$22.92
|
| Rate for Payer: Prime Health Services Commercial |
$29.97
|
| Rate for Payer: Riverside University Health System MISP |
$14.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.63
|
| Rate for Payer: United Healthcare All Other HMO |
$17.63
|
| Rate for Payer: United Healthcare HMO Rider |
$17.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.97
|
| Rate for Payer: Vantage Medical Group Senior |
$29.97
|
|
|
HC SUTURE PLAIN 3-0 102832
|
Facility
|
IP
|
$35.26
|
|
| Hospital Charge Code |
901694611
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.05 |
| Max. Negotiated Rate |
$31.73 |
| Rate for Payer: Adventist Health Commercial |
$7.05
|
| Rate for Payer: Cash Price |
$15.87
|
| Rate for Payer: Central Health Plan Commercial |
$28.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.10
|
| Rate for Payer: EPIC Health Plan Senior |
$14.10
|
| Rate for Payer: Galaxy Health WC |
$29.97
|
| Rate for Payer: Global Benefits Group Commercial |
$21.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.05
|
| Rate for Payer: Multiplan Commercial |
$26.45
|
| Rate for Payer: Networks By Design Commercial |
$22.92
|
| Rate for Payer: Prime Health Services Commercial |
$29.97
|
|
|
HC SUTURE PLAIN 3-0 27" T-29
|
Facility
|
IP
|
$37.97
|
|
| Hospital Charge Code |
901694613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.59 |
| Max. Negotiated Rate |
$34.17 |
| Rate for Payer: Adventist Health Commercial |
$7.59
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Central Health Plan Commercial |
$30.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.19
|
| Rate for Payer: EPIC Health Plan Senior |
$15.19
|
| Rate for Payer: Galaxy Health WC |
$32.27
|
| Rate for Payer: Global Benefits Group Commercial |
$22.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.59
|
| Rate for Payer: Multiplan Commercial |
$28.48
|
| Rate for Payer: Networks By Design Commercial |
$24.68
|
| Rate for Payer: Prime Health Services Commercial |
$32.27
|
|
|
HC SUTURE PLAIN 3-0 27" T-29
|
Facility
|
OP
|
$37.97
|
|
| Hospital Charge Code |
901694613
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.59 |
| Max. Negotiated Rate |
$34.17 |
| Rate for Payer: Adventist Health Commercial |
$7.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.09
|
| Rate for Payer: Blue Shield of California Commercial |
$24.07
|
| Rate for Payer: Blue Shield of California EPN |
$15.15
|
| Rate for Payer: Cash Price |
$17.09
|
| Rate for Payer: Central Health Plan Commercial |
$30.38
|
| Rate for Payer: Cigna of CA HMO |
$24.30
|
| Rate for Payer: Cigna of CA PPO |
$28.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$26.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.19
|
| Rate for Payer: EPIC Health Plan Senior |
$15.19
|
| Rate for Payer: Galaxy Health WC |
$32.27
|
| Rate for Payer: Global Benefits Group Commercial |
$22.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$26.58
|
| Rate for Payer: Multiplan Commercial |
$28.48
|
| Rate for Payer: Networks By Design Commercial |
$24.68
|
| Rate for Payer: Prime Health Services Commercial |
$32.27
|
| Rate for Payer: Riverside University Health System MISP |
$15.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.98
|
| Rate for Payer: United Healthcare All Other HMO |
$18.98
|
| Rate for Payer: United Healthcare HMO Rider |
$18.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.27
|
| Rate for Payer: Vantage Medical Group Senior |
$32.27
|
|
|
HC SUTURE PLAIN 6-0 G-1 101036
|
Facility
|
IP
|
$82.00
|
|
| Hospital Charge Code |
901692002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC SUTURE PLAIN 6-0 G-1 101036
|
Facility
|
OP
|
$82.00
|
|
| Hospital Charge Code |
901692002
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Adventist Health Commercial |
$16.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$47.70
|
| Rate for Payer: Blue Shield of California Commercial |
$51.99
|
| Rate for Payer: Blue Shield of California EPN |
$32.72
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.70
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Senior |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$57.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Riverside University Health System MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC SUTURE PLAIN GC3-0 CI1 102834
|
Facility
|
OP
|
$29.27
|
|
| Hospital Charge Code |
901694632
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Adventist Health Commercial |
$5.85
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.03
|
| Rate for Payer: Blue Shield of California Commercial |
$18.56
|
| Rate for Payer: Blue Shield of California EPN |
$11.68
|
| Rate for Payer: Cash Price |
$13.17
|
| Rate for Payer: Central Health Plan Commercial |
$23.42
|
| Rate for Payer: Cigna of CA HMO |
$18.73
|
| Rate for Payer: Cigna of CA PPO |
$21.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.71
|
| Rate for Payer: EPIC Health Plan Senior |
$11.71
|
| Rate for Payer: Galaxy Health WC |
$24.88
|
| Rate for Payer: Global Benefits Group Commercial |
$17.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.49
|
| Rate for Payer: Multiplan Commercial |
$21.95
|
| Rate for Payer: Networks By Design Commercial |
$19.03
|
| Rate for Payer: Prime Health Services Commercial |
$24.88
|
| Rate for Payer: Riverside University Health System MISP |
$11.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.56
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.63
|
| Rate for Payer: United Healthcare All Other HMO |
$14.63
|
| Rate for Payer: United Healthcare HMO Rider |
$14.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.88
|
| Rate for Payer: Vantage Medical Group Senior |
$24.88
|
|
|
HC SUTURE PLAIN GC3-0 CI1 102834
|
Facility
|
IP
|
$29.27
|
|
| Hospital Charge Code |
901694632
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.85 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Adventist Health Commercial |
$5.85
|
| Rate for Payer: Cash Price |
$13.17
|
| Rate for Payer: Central Health Plan Commercial |
$23.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.71
|
| Rate for Payer: EPIC Health Plan Senior |
$11.71
|
| Rate for Payer: Galaxy Health WC |
$24.88
|
| Rate for Payer: Global Benefits Group Commercial |
$17.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.85
|
| Rate for Payer: Multiplan Commercial |
$21.95
|
| Rate for Payer: Networks By Design Commercial |
$19.03
|
| Rate for Payer: Prime Health Services Commercial |
$24.88
|
|
|
HC SUTURE PLAIN GUT 4-0 P-3
|
Facility
|
OP
|
$38.62
|
|
| Hospital Charge Code |
901694889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.47
|
| Rate for Payer: Blue Shield of California Commercial |
$24.49
|
| Rate for Payer: Blue Shield of California EPN |
$15.41
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.03
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Riverside University Health System MISP |
$15.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
|
HC SUTURE PLAIN GUT 4-0 P-3
|
Facility
|
IP
|
$38.62
|
|
| Hospital Charge Code |
901694889
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Adventist Health Commercial |
$7.72
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Senior |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
|
HC SUTURE PLAIN GUT 5-0 18 10044
|
Facility
|
OP
|
$66.99
|
|
| Hospital Charge Code |
901694886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$60.29 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$50.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.97
|
| Rate for Payer: Blue Shield of California Commercial |
$42.47
|
| Rate for Payer: Blue Shield of California EPN |
$26.73
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Central Health Plan Commercial |
$53.59
|
| Rate for Payer: Cigna of CA HMO |
$42.87
|
| Rate for Payer: Cigna of CA PPO |
$49.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.80
|
| Rate for Payer: EPIC Health Plan Senior |
$26.80
|
| Rate for Payer: Galaxy Health WC |
$56.94
|
| Rate for Payer: Global Benefits Group Commercial |
$40.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$60.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$24.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$46.89
|
| Rate for Payer: Multiplan Commercial |
$50.24
|
| Rate for Payer: Networks By Design Commercial |
$43.54
|
| Rate for Payer: Prime Health Services Commercial |
$56.94
|
| Rate for Payer: Riverside University Health System MISP |
$26.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.49
|
| Rate for Payer: United Healthcare All Other HMO |
$33.49
|
| Rate for Payer: United Healthcare HMO Rider |
$33.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.94
|
| Rate for Payer: Vantage Medical Group Senior |
$56.94
|
|
|
HC SUTURE PLAIN GUT 5-0 18 10044
|
Facility
|
IP
|
$66.99
|
|
| Hospital Charge Code |
901694886
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.40 |
| Max. Negotiated Rate |
$60.29 |
| Rate for Payer: Adventist Health Commercial |
$13.40
|
| Rate for Payer: Cash Price |
$30.15
|
| Rate for Payer: Central Health Plan Commercial |
$53.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$46.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.80
|
| Rate for Payer: EPIC Health Plan Senior |
$26.80
|
| Rate for Payer: Galaxy Health WC |
$56.94
|
| Rate for Payer: Global Benefits Group Commercial |
$40.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$60.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$42.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$39.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.40
|
| Rate for Payer: Multiplan Commercial |
$50.24
|
| Rate for Payer: Networks By Design Commercial |
$43.54
|
| Rate for Payer: Prime Health Services Commercial |
$56.94
|
|
|
HC SUTURE PLAIN GUT 5-0 18" P-2
|
Facility
|
OP
|
$65.60
|
|
| Hospital Charge Code |
901601963
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$59.04 |
| Rate for Payer: Adventist Health Commercial |
$13.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.16
|
| Rate for Payer: Blue Shield of California Commercial |
$41.59
|
| Rate for Payer: Blue Shield of California EPN |
$26.17
|
| Rate for Payer: Cash Price |
$29.52
|
| Rate for Payer: Central Health Plan Commercial |
$52.48
|
| Rate for Payer: Cigna of CA HMO |
$41.98
|
| Rate for Payer: Cigna of CA PPO |
$48.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.76
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.24
|
| Rate for Payer: EPIC Health Plan Senior |
$26.24
|
| Rate for Payer: Galaxy Health WC |
$55.76
|
| Rate for Payer: Global Benefits Group Commercial |
$39.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45.92
|
| Rate for Payer: Multiplan Commercial |
$49.20
|
| Rate for Payer: Networks By Design Commercial |
$42.64
|
| Rate for Payer: Prime Health Services Commercial |
$55.76
|
| Rate for Payer: Riverside University Health System MISP |
$26.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.80
|
| Rate for Payer: United Healthcare All Other HMO |
$32.80
|
| Rate for Payer: United Healthcare HMO Rider |
$32.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.76
|
| Rate for Payer: Vantage Medical Group Senior |
$55.76
|
|
|
HC SUTURE PLAIN GUT 5-0 18" P-2
|
Facility
|
IP
|
$65.60
|
|
| Hospital Charge Code |
901601963
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.12 |
| Max. Negotiated Rate |
$59.04 |
| Rate for Payer: Adventist Health Commercial |
$13.12
|
| Rate for Payer: Cash Price |
$29.52
|
| Rate for Payer: Central Health Plan Commercial |
$52.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.24
|
| Rate for Payer: EPIC Health Plan Senior |
$26.24
|
| Rate for Payer: Galaxy Health WC |
$55.76
|
| Rate for Payer: Global Benefits Group Commercial |
$39.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.12
|
| Rate for Payer: Multiplan Commercial |
$49.20
|
| Rate for Payer: Networks By Design Commercial |
$42.64
|
| Rate for Payer: Prime Health Services Commercial |
$55.76
|
|
|
HC SUTURE PLAIN GUT 6-0 18" PC1
|
Facility
|
IP
|
$48.46
|
|
| Hospital Charge Code |
901601964
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$43.61 |
| Rate for Payer: Adventist Health Commercial |
$9.69
|
| Rate for Payer: Cash Price |
$21.81
|
| Rate for Payer: Central Health Plan Commercial |
$38.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.38
|
| Rate for Payer: EPIC Health Plan Senior |
$19.38
|
| Rate for Payer: Galaxy Health WC |
$41.19
|
| Rate for Payer: Global Benefits Group Commercial |
$29.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.69
|
| Rate for Payer: Multiplan Commercial |
$36.34
|
| Rate for Payer: Networks By Design Commercial |
$31.50
|
| Rate for Payer: Prime Health Services Commercial |
$41.19
|
|
|
HC SUTURE PLAIN GUT 6-0 18" PC1
|
Facility
|
OP
|
$48.46
|
|
| Hospital Charge Code |
901601964
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.69 |
| Max. Negotiated Rate |
$43.61 |
| Rate for Payer: Adventist Health Commercial |
$9.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$29.43
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.19
|
| Rate for Payer: Blue Shield of California Commercial |
$30.72
|
| Rate for Payer: Blue Shield of California EPN |
$19.34
|
| Rate for Payer: Cash Price |
$21.81
|
| Rate for Payer: Central Health Plan Commercial |
$38.77
|
| Rate for Payer: Cigna of CA HMO |
$31.01
|
| Rate for Payer: Cigna of CA PPO |
$35.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$41.19
|
| Rate for Payer: Dignity Health Medicare Advantage |
$41.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$33.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.38
|
| Rate for Payer: EPIC Health Plan Senior |
$19.38
|
| Rate for Payer: Galaxy Health WC |
$41.19
|
| Rate for Payer: Global Benefits Group Commercial |
$29.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$30.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$28.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$33.92
|
| Rate for Payer: Multiplan Commercial |
$36.34
|
| Rate for Payer: Networks By Design Commercial |
$31.50
|
| Rate for Payer: Prime Health Services Commercial |
$41.19
|
| Rate for Payer: Riverside University Health System MISP |
$19.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.23
|
| Rate for Payer: United Healthcare All Other HMO |
$24.23
|
| Rate for Payer: United Healthcare HMO Rider |
$24.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.19
|
| Rate for Payer: Vantage Medical Group Senior |
$41.19
|
|
|
HC SUTURE PLAIN TIES 2-0 102840
|
Facility
|
IP
|
$247.59
|
|
| Hospital Charge Code |
901694610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.52 |
| Max. Negotiated Rate |
$222.83 |
| Rate for Payer: Adventist Health Commercial |
$49.52
|
| Rate for Payer: Cash Price |
$111.42
|
| Rate for Payer: Central Health Plan Commercial |
$198.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$173.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.04
|
| Rate for Payer: EPIC Health Plan Senior |
$99.04
|
| Rate for Payer: Galaxy Health WC |
$210.45
|
| Rate for Payer: Global Benefits Group Commercial |
$148.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$222.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$157.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.52
|
| Rate for Payer: Multiplan Commercial |
$185.69
|
| Rate for Payer: Networks By Design Commercial |
$160.93
|
| Rate for Payer: Prime Health Services Commercial |
$210.45
|
|
|
HC SUTURE PLAIN TIES 2-0 102840
|
Facility
|
OP
|
$247.59
|
|
| Hospital Charge Code |
901694610
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$49.52 |
| Max. Negotiated Rate |
$222.83 |
| Rate for Payer: Adventist Health Commercial |
$49.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$150.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$210.45
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$136.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$185.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$119.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$144.02
|
| Rate for Payer: Blue Shield of California Commercial |
$156.97
|
| Rate for Payer: Blue Shield of California EPN |
$98.79
|
| Rate for Payer: Cash Price |
$111.42
|
| Rate for Payer: Central Health Plan Commercial |
$198.07
|
| Rate for Payer: Cigna of CA HMO |
$158.46
|
| Rate for Payer: Cigna of CA PPO |
$183.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$210.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$210.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$210.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$173.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$99.04
|
| Rate for Payer: EPIC Health Plan Senior |
$99.04
|
| Rate for Payer: Galaxy Health WC |
$210.45
|
| Rate for Payer: Global Benefits Group Commercial |
$148.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$222.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$157.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$89.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$146.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$49.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$173.31
|
| Rate for Payer: Multiplan Commercial |
$185.69
|
| Rate for Payer: Networks By Design Commercial |
$160.93
|
| Rate for Payer: Prime Health Services Commercial |
$210.45
|
| Rate for Payer: Riverside University Health System MISP |
$99.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$148.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$148.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$123.80
|
| Rate for Payer: United Healthcare All Other HMO |
$123.80
|
| Rate for Payer: United Healthcare HMO Rider |
$123.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$123.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$210.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$210.45
|
| Rate for Payer: Vantage Medical Group Senior |
$210.45
|
|
|
HC SUTURE PROLENE 0 101004
|
Facility
|
IP
|
$16.81
|
|
| Hospital Charge Code |
901693104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$15.13 |
| Rate for Payer: Adventist Health Commercial |
$3.36
|
| Rate for Payer: Cash Price |
$7.56
|
| Rate for Payer: Central Health Plan Commercial |
$13.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.72
|
| Rate for Payer: EPIC Health Plan Senior |
$6.72
|
| Rate for Payer: Galaxy Health WC |
$14.29
|
| Rate for Payer: Global Benefits Group Commercial |
$10.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: Multiplan Commercial |
$12.61
|
| Rate for Payer: Networks By Design Commercial |
$10.93
|
| Rate for Payer: Prime Health Services Commercial |
$14.29
|
|
