|
HC SUTURE PROLENE 6-0 18"
|
Facility
|
IP
|
$65.44
|
|
| Hospital Charge Code |
901603486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$58.90 |
| Rate for Payer: Adventist Health Commercial |
$13.09
|
| Rate for Payer: Cash Price |
$29.45
|
| Rate for Payer: Central Health Plan Commercial |
$52.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.18
|
| Rate for Payer: EPIC Health Plan Senior |
$26.18
|
| Rate for Payer: Galaxy Health WC |
$55.62
|
| Rate for Payer: Global Benefits Group Commercial |
$39.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.09
|
| Rate for Payer: Multiplan Commercial |
$49.08
|
| Rate for Payer: Networks By Design Commercial |
$42.54
|
| Rate for Payer: Prime Health Services Commercial |
$55.62
|
|
|
HC SUTURE PROLENE 6-0 18"
|
Facility
|
OP
|
$65.44
|
|
| Hospital Charge Code |
901603486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.09 |
| Max. Negotiated Rate |
$58.90 |
| Rate for Payer: Adventist Health Commercial |
$13.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$55.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.07
|
| Rate for Payer: Blue Shield of California Commercial |
$41.49
|
| Rate for Payer: Blue Shield of California EPN |
$26.11
|
| Rate for Payer: Cash Price |
$29.45
|
| Rate for Payer: Central Health Plan Commercial |
$52.35
|
| Rate for Payer: Cigna of CA HMO |
$41.88
|
| Rate for Payer: Cigna of CA PPO |
$48.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$55.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$55.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$55.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.18
|
| Rate for Payer: EPIC Health Plan Senior |
$26.18
|
| Rate for Payer: Galaxy Health WC |
$55.62
|
| Rate for Payer: Global Benefits Group Commercial |
$39.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.90
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$41.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.75
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45.81
|
| Rate for Payer: Multiplan Commercial |
$49.08
|
| Rate for Payer: Networks By Design Commercial |
$42.54
|
| Rate for Payer: Prime Health Services Commercial |
$55.62
|
| Rate for Payer: Riverside University Health System MISP |
$26.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.72
|
| Rate for Payer: United Healthcare All Other HMO |
$32.72
|
| Rate for Payer: United Healthcare HMO Rider |
$32.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$55.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$55.62
|
| Rate for Payer: Vantage Medical Group Senior |
$55.62
|
|
|
HC SUTURE PROLENE 6-0 18" P-3
|
Facility
|
IP
|
$60.02
|
|
| Hospital Charge Code |
901601975
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$54.02 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$27.01
|
| Rate for Payer: Central Health Plan Commercial |
$48.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.01
|
| Rate for Payer: EPIC Health Plan Senior |
$24.01
|
| Rate for Payer: Galaxy Health WC |
$51.02
|
| Rate for Payer: Global Benefits Group Commercial |
$36.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Multiplan Commercial |
$45.02
|
| Rate for Payer: Networks By Design Commercial |
$39.01
|
| Rate for Payer: Prime Health Services Commercial |
$51.02
|
|
|
HC SUTURE PROLENE 6-0 18" P-3
|
Facility
|
OP
|
$60.02
|
|
| Hospital Charge Code |
901601975
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.00 |
| Max. Negotiated Rate |
$54.02 |
| Rate for Payer: Adventist Health Commercial |
$12.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.91
|
| Rate for Payer: Blue Shield of California Commercial |
$38.05
|
| Rate for Payer: Blue Shield of California EPN |
$23.95
|
| Rate for Payer: Cash Price |
$27.01
|
| Rate for Payer: Central Health Plan Commercial |
$48.02
|
| Rate for Payer: Cigna of CA HMO |
$38.41
|
| Rate for Payer: Cigna of CA PPO |
$44.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$42.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.01
|
| Rate for Payer: EPIC Health Plan Senior |
$24.01
|
| Rate for Payer: Galaxy Health WC |
$51.02
|
| Rate for Payer: Global Benefits Group Commercial |
$36.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$38.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$35.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$42.01
|
| Rate for Payer: Multiplan Commercial |
$45.02
|
| Rate for Payer: Networks By Design Commercial |
$39.01
|
| Rate for Payer: Prime Health Services Commercial |
$51.02
|
| Rate for Payer: Riverside University Health System MISP |
$24.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.01
|
| Rate for Payer: United Healthcare All Other HMO |
$30.01
|
| Rate for Payer: United Healthcare HMO Rider |
$30.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.02
|
| Rate for Payer: Vantage Medical Group Senior |
$51.02
|
|
|
HC SUTURE PROLENE 6-0 DBL ARM RB
|
Facility
|
IP
|
$41.82
|
|
| Hospital Charge Code |
901603044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.36 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Adventist Health Commercial |
$8.36
|
| Rate for Payer: Cash Price |
$18.82
|
| Rate for Payer: Central Health Plan Commercial |
$33.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.73
|
| Rate for Payer: EPIC Health Plan Senior |
$16.73
|
| Rate for Payer: Galaxy Health WC |
$35.55
|
| Rate for Payer: Global Benefits Group Commercial |
$25.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.36
|
| Rate for Payer: Multiplan Commercial |
$31.36
|
| Rate for Payer: Networks By Design Commercial |
$27.18
|
| Rate for Payer: Prime Health Services Commercial |
$35.55
|
|
|
HC SUTURE PROLENE 6-0 DBL ARM RB
|
Facility
|
OP
|
$41.82
|
|
| Hospital Charge Code |
901603044
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.36 |
| Max. Negotiated Rate |
$37.64 |
| Rate for Payer: Adventist Health Commercial |
$8.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$35.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.33
|
| Rate for Payer: Blue Shield of California Commercial |
$26.51
|
| Rate for Payer: Blue Shield of California EPN |
$16.69
|
| Rate for Payer: Cash Price |
$18.82
|
| Rate for Payer: Central Health Plan Commercial |
$33.46
|
| Rate for Payer: Cigna of CA HMO |
$26.76
|
| Rate for Payer: Cigna of CA PPO |
$30.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$35.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$35.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$29.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.73
|
| Rate for Payer: EPIC Health Plan Senior |
$16.73
|
| Rate for Payer: Galaxy Health WC |
$35.55
|
| Rate for Payer: Global Benefits Group Commercial |
$25.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$29.27
|
| Rate for Payer: Multiplan Commercial |
$31.36
|
| Rate for Payer: Networks By Design Commercial |
$27.18
|
| Rate for Payer: Prime Health Services Commercial |
$35.55
|
| Rate for Payer: Riverside University Health System MISP |
$16.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.91
|
| Rate for Payer: United Healthcare All Other HMO |
$20.91
|
| Rate for Payer: United Healthcare HMO Rider |
$20.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$35.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$35.55
|
| Rate for Payer: Vantage Medical Group Senior |
$35.55
|
|
|
HC SUTURE PROLENE 7-0 24" BV-1
|
Facility
|
OP
|
$117.88
|
|
| Hospital Charge Code |
901604393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$106.09 |
| Rate for Payer: Adventist Health Commercial |
$23.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$71.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$100.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$88.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$57.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$68.57
|
| Rate for Payer: Blue Shield of California Commercial |
$74.74
|
| Rate for Payer: Blue Shield of California EPN |
$47.03
|
| Rate for Payer: Cash Price |
$53.05
|
| Rate for Payer: Central Health Plan Commercial |
$94.30
|
| Rate for Payer: Cigna of CA HMO |
$75.44
|
| Rate for Payer: Cigna of CA PPO |
$87.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$100.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$100.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$82.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.15
|
| Rate for Payer: EPIC Health Plan Senior |
$47.15
|
| Rate for Payer: Galaxy Health WC |
$100.20
|
| Rate for Payer: Global Benefits Group Commercial |
$70.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$106.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$69.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$82.52
|
| Rate for Payer: Multiplan Commercial |
$88.41
|
| Rate for Payer: Networks By Design Commercial |
$76.62
|
| Rate for Payer: Prime Health Services Commercial |
$100.20
|
| Rate for Payer: Riverside University Health System MISP |
$47.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$58.94
|
| Rate for Payer: United Healthcare All Other HMO |
$58.94
|
| Rate for Payer: United Healthcare HMO Rider |
$58.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$58.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$100.20
|
| Rate for Payer: Vantage Medical Group Senior |
$100.20
|
|
|
HC SUTURE PROLENE 7-0 24" BV-1
|
Facility
|
IP
|
$117.88
|
|
| Hospital Charge Code |
901604393
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$23.58 |
| Max. Negotiated Rate |
$106.09 |
| Rate for Payer: Adventist Health Commercial |
$23.58
|
| Rate for Payer: Cash Price |
$53.05
|
| Rate for Payer: Central Health Plan Commercial |
$94.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$82.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.15
|
| Rate for Payer: EPIC Health Plan Senior |
$47.15
|
| Rate for Payer: Galaxy Health WC |
$100.20
|
| Rate for Payer: Global Benefits Group Commercial |
$70.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$106.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$69.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.58
|
| Rate for Payer: Multiplan Commercial |
$88.41
|
| Rate for Payer: Networks By Design Commercial |
$76.62
|
| Rate for Payer: Prime Health Services Commercial |
$100.20
|
|
|
HC SUTURE SILK 0 18"
|
Facility
|
IP
|
$24.76
|
|
| Hospital Charge Code |
901603230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$22.28 |
| Rate for Payer: Adventist Health Commercial |
$4.95
|
| Rate for Payer: Cash Price |
$11.14
|
| Rate for Payer: Central Health Plan Commercial |
$19.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.90
|
| Rate for Payer: EPIC Health Plan Senior |
$9.90
|
| Rate for Payer: Galaxy Health WC |
$21.05
|
| Rate for Payer: Global Benefits Group Commercial |
$14.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.95
|
| Rate for Payer: Multiplan Commercial |
$18.57
|
| Rate for Payer: Networks By Design Commercial |
$16.09
|
| Rate for Payer: Prime Health Services Commercial |
$21.05
|
|
|
HC SUTURE SILK 0 18"
|
Facility
|
OP
|
$24.76
|
|
| Hospital Charge Code |
901603230
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$22.28 |
| Rate for Payer: Adventist Health Commercial |
$4.95
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$15.70
|
| Rate for Payer: Blue Shield of California EPN |
$9.88
|
| Rate for Payer: Cash Price |
$11.14
|
| Rate for Payer: Central Health Plan Commercial |
$19.81
|
| Rate for Payer: Cigna of CA HMO |
$15.85
|
| Rate for Payer: Cigna of CA PPO |
$18.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.90
|
| Rate for Payer: EPIC Health Plan Senior |
$9.90
|
| Rate for Payer: Galaxy Health WC |
$21.05
|
| Rate for Payer: Global Benefits Group Commercial |
$14.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$17.33
|
| Rate for Payer: Multiplan Commercial |
$18.57
|
| Rate for Payer: Networks By Design Commercial |
$16.09
|
| Rate for Payer: Prime Health Services Commercial |
$21.05
|
| Rate for Payer: Riverside University Health System MISP |
$9.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.38
|
| Rate for Payer: United Healthcare All Other HMO |
$12.38
|
| Rate for Payer: United Healthcare HMO Rider |
$12.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.05
|
| Rate for Payer: Vantage Medical Group Senior |
$21.05
|
|
|
HC SUTURE SILK 0 18" 678H
|
Facility
|
IP
|
$12.87
|
|
| Hospital Charge Code |
901601275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$11.58 |
| Rate for Payer: Adventist Health Commercial |
$2.57
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Central Health Plan Commercial |
$10.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: EPIC Health Plan Senior |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.57
|
| Rate for Payer: Multiplan Commercial |
$9.65
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
|
|
HC SUTURE SILK 0 18" 678H
|
Facility
|
OP
|
$12.87
|
|
| Hospital Charge Code |
901601275
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$11.58 |
| Rate for Payer: Adventist Health Commercial |
$2.57
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.49
|
| Rate for Payer: Blue Shield of California Commercial |
$8.16
|
| Rate for Payer: Blue Shield of California EPN |
$5.14
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Central Health Plan Commercial |
$10.30
|
| Rate for Payer: Cigna of CA HMO |
$8.24
|
| Rate for Payer: Cigna of CA PPO |
$9.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: EPIC Health Plan Senior |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.01
|
| Rate for Payer: Multiplan Commercial |
$9.65
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
| Rate for Payer: Riverside University Health System MISP |
$5.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.43
|
| Rate for Payer: United Healthcare All Other HMO |
$6.43
|
| Rate for Payer: United Healthcare HMO Rider |
$6.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.94
|
| Rate for Payer: Vantage Medical Group Senior |
$10.94
|
|
|
HC SUTURE SILK 0 18" BR 119068
|
Facility
|
IP
|
$13.94
|
|
| Hospital Charge Code |
901691006
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Cash Price |
$6.27
|
| Rate for Payer: Central Health Plan Commercial |
$11.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.79
|
| Rate for Payer: Multiplan Commercial |
$10.46
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
|
|
HC SUTURE SILK 0 18" BR 119068
|
Facility
|
OP
|
$13.94
|
|
| Hospital Charge Code |
901691006
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.11
|
| Rate for Payer: Blue Shield of California Commercial |
$8.84
|
| Rate for Payer: Blue Shield of California EPN |
$5.56
|
| Rate for Payer: Cash Price |
$6.27
|
| Rate for Payer: Central Health Plan Commercial |
$11.15
|
| Rate for Payer: Cigna of CA HMO |
$8.92
|
| Rate for Payer: Cigna of CA PPO |
$10.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.76
|
| Rate for Payer: Multiplan Commercial |
$10.46
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
| Rate for Payer: Riverside University Health System MISP |
$5.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.97
|
| Rate for Payer: United Healthcare All Other HMO |
$6.97
|
| Rate for Payer: United Healthcare HMO Rider |
$6.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.85
|
| Rate for Payer: Vantage Medical Group Senior |
$11.85
|
|
|
HC SUTURE SILK 0 30" 680H
|
Facility
|
IP
|
$18.04
|
|
| Hospital Charge Code |
901604311
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$16.24 |
| Rate for Payer: Adventist Health Commercial |
$3.61
|
| Rate for Payer: Cash Price |
$8.12
|
| Rate for Payer: Central Health Plan Commercial |
$14.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.22
|
| Rate for Payer: EPIC Health Plan Senior |
$7.22
|
| Rate for Payer: Galaxy Health WC |
$15.33
|
| Rate for Payer: Global Benefits Group Commercial |
$10.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.61
|
| Rate for Payer: Multiplan Commercial |
$13.53
|
| Rate for Payer: Networks By Design Commercial |
$11.73
|
| Rate for Payer: Prime Health Services Commercial |
$15.33
|
|
|
HC SUTURE SILK 0 30" 680H
|
Facility
|
OP
|
$18.04
|
|
| Hospital Charge Code |
901604311
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$16.24 |
| Rate for Payer: Adventist Health Commercial |
$3.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.49
|
| Rate for Payer: Blue Shield of California Commercial |
$11.44
|
| Rate for Payer: Blue Shield of California EPN |
$7.20
|
| Rate for Payer: Cash Price |
$8.12
|
| Rate for Payer: Central Health Plan Commercial |
$14.43
|
| Rate for Payer: Cigna of CA HMO |
$11.55
|
| Rate for Payer: Cigna of CA PPO |
$13.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$12.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.22
|
| Rate for Payer: EPIC Health Plan Senior |
$7.22
|
| Rate for Payer: Galaxy Health WC |
$15.33
|
| Rate for Payer: Global Benefits Group Commercial |
$10.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$11.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12.63
|
| Rate for Payer: Multiplan Commercial |
$13.53
|
| Rate for Payer: Networks By Design Commercial |
$11.73
|
| Rate for Payer: Prime Health Services Commercial |
$15.33
|
| Rate for Payer: Riverside University Health System MISP |
$7.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.02
|
| Rate for Payer: United Healthcare All Other HMO |
$9.02
|
| Rate for Payer: United Healthcare HMO Rider |
$9.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.33
|
| Rate for Payer: Vantage Medical Group Senior |
$15.33
|
|
|
HC SUTURE SILK 2-0 18" FS
|
Facility
|
IP
|
$17.06
|
|
| Hospital Charge Code |
901601276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$15.35 |
| Rate for Payer: Adventist Health Commercial |
$3.41
|
| Rate for Payer: Cash Price |
$7.68
|
| Rate for Payer: Central Health Plan Commercial |
$13.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.82
|
| Rate for Payer: EPIC Health Plan Senior |
$6.82
|
| Rate for Payer: Galaxy Health WC |
$14.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: Multiplan Commercial |
$12.79
|
| Rate for Payer: Networks By Design Commercial |
$11.09
|
| Rate for Payer: Prime Health Services Commercial |
$14.50
|
|
|
HC SUTURE SILK 2-0 18" FS
|
Facility
|
OP
|
$17.06
|
|
| Hospital Charge Code |
901601276
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.41 |
| Max. Negotiated Rate |
$15.35 |
| Rate for Payer: Adventist Health Commercial |
$3.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.92
|
| Rate for Payer: Blue Shield of California Commercial |
$10.82
|
| Rate for Payer: Blue Shield of California EPN |
$6.81
|
| Rate for Payer: Cash Price |
$7.68
|
| Rate for Payer: Central Health Plan Commercial |
$13.65
|
| Rate for Payer: Cigna of CA HMO |
$10.92
|
| Rate for Payer: Cigna of CA PPO |
$12.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.82
|
| Rate for Payer: EPIC Health Plan Senior |
$6.82
|
| Rate for Payer: Galaxy Health WC |
$14.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.94
|
| Rate for Payer: Multiplan Commercial |
$12.79
|
| Rate for Payer: Networks By Design Commercial |
$11.09
|
| Rate for Payer: Prime Health Services Commercial |
$14.50
|
| Rate for Payer: Riverside University Health System MISP |
$6.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.53
|
| Rate for Payer: United Healthcare All Other HMO |
$8.53
|
| Rate for Payer: United Healthcare HMO Rider |
$8.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.50
|
| Rate for Payer: Vantage Medical Group Senior |
$14.50
|
|
|
HC SUTURE SILK 2-0 24" 100301
|
Facility
|
IP
|
$25.75
|
|
| Hospital Charge Code |
901694654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Central Health Plan Commercial |
$20.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.15
|
| Rate for Payer: Multiplan Commercial |
$19.31
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
|
|
HC SUTURE SILK 2-0 24" 100301
|
Facility
|
OP
|
$25.75
|
|
| Hospital Charge Code |
901694654
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.98
|
| Rate for Payer: Blue Shield of California Commercial |
$16.33
|
| Rate for Payer: Blue Shield of California EPN |
$10.27
|
| Rate for Payer: Cash Price |
$11.59
|
| Rate for Payer: Central Health Plan Commercial |
$20.60
|
| Rate for Payer: Cigna of CA HMO |
$16.48
|
| Rate for Payer: Cigna of CA PPO |
$19.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18.02
|
| Rate for Payer: Multiplan Commercial |
$19.31
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
| Rate for Payer: Riverside University Health System MISP |
$10.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO |
$12.88
|
| Rate for Payer: United Healthcare HMO Rider |
$12.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.89
|
| Rate for Payer: Vantage Medical Group Senior |
$21.89
|
|
|
HC SUTURE SILK 2-0 30" SH
|
Facility
|
OP
|
$13.53
|
|
| Hospital Charge Code |
901604004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$12.18 |
| Rate for Payer: Adventist Health Commercial |
$2.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.15
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.55
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.87
|
| Rate for Payer: Blue Shield of California Commercial |
$8.58
|
| Rate for Payer: Blue Shield of California EPN |
$5.40
|
| Rate for Payer: Cash Price |
$6.09
|
| Rate for Payer: Central Health Plan Commercial |
$10.82
|
| Rate for Payer: Cigna of CA HMO |
$8.66
|
| Rate for Payer: Cigna of CA PPO |
$10.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.41
|
| Rate for Payer: EPIC Health Plan Senior |
$5.41
|
| Rate for Payer: Galaxy Health WC |
$11.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.47
|
| Rate for Payer: Multiplan Commercial |
$10.15
|
| Rate for Payer: Networks By Design Commercial |
$8.79
|
| Rate for Payer: Prime Health Services Commercial |
$11.50
|
| Rate for Payer: Riverside University Health System MISP |
$5.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.76
|
| Rate for Payer: United Healthcare All Other HMO |
$6.76
|
| Rate for Payer: United Healthcare HMO Rider |
$6.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.76
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.50
|
| Rate for Payer: Vantage Medical Group Senior |
$11.50
|
|
|
HC SUTURE SILK 2-0 30" SH
|
Facility
|
IP
|
$13.53
|
|
| Hospital Charge Code |
901604004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.71 |
| Max. Negotiated Rate |
$12.18 |
| Rate for Payer: Adventist Health Commercial |
$2.71
|
| Rate for Payer: Cash Price |
$6.09
|
| Rate for Payer: Central Health Plan Commercial |
$10.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.41
|
| Rate for Payer: EPIC Health Plan Senior |
$5.41
|
| Rate for Payer: Galaxy Health WC |
$11.50
|
| Rate for Payer: Global Benefits Group Commercial |
$8.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.71
|
| Rate for Payer: Multiplan Commercial |
$10.15
|
| Rate for Payer: Networks By Design Commercial |
$8.79
|
| Rate for Payer: Prime Health Services Commercial |
$11.50
|
|
|
HC SUTURE SILK 2-0 BRAID 128055
|
Facility
|
IP
|
$14.60
|
|
| Hospital Charge Code |
901694617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$13.14 |
| Rate for Payer: Adventist Health Commercial |
$2.92
|
| Rate for Payer: Cash Price |
$6.57
|
| Rate for Payer: Central Health Plan Commercial |
$11.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.84
|
| Rate for Payer: EPIC Health Plan Senior |
$5.84
|
| Rate for Payer: Galaxy Health WC |
$12.41
|
| Rate for Payer: Global Benefits Group Commercial |
$8.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.92
|
| Rate for Payer: Multiplan Commercial |
$10.95
|
| Rate for Payer: Networks By Design Commercial |
$9.49
|
| Rate for Payer: Prime Health Services Commercial |
$12.41
|
|
|
HC SUTURE SILK 2-0 BRAID 128055
|
Facility
|
OP
|
$14.60
|
|
| Hospital Charge Code |
901694617
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$13.14 |
| Rate for Payer: Adventist Health Commercial |
$2.92
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.49
|
| Rate for Payer: Blue Shield of California Commercial |
$9.26
|
| Rate for Payer: Blue Shield of California EPN |
$5.83
|
| Rate for Payer: Cash Price |
$6.57
|
| Rate for Payer: Central Health Plan Commercial |
$11.68
|
| Rate for Payer: Cigna of CA HMO |
$9.34
|
| Rate for Payer: Cigna of CA PPO |
$10.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.84
|
| Rate for Payer: EPIC Health Plan Senior |
$5.84
|
| Rate for Payer: Galaxy Health WC |
$12.41
|
| Rate for Payer: Global Benefits Group Commercial |
$8.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.14
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.22
|
| Rate for Payer: Multiplan Commercial |
$10.95
|
| Rate for Payer: Networks By Design Commercial |
$9.49
|
| Rate for Payer: Prime Health Services Commercial |
$12.41
|
| Rate for Payer: Riverside University Health System MISP |
$5.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.30
|
| Rate for Payer: United Healthcare All Other HMO |
$7.30
|
| Rate for Payer: United Healthcare HMO Rider |
$7.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.41
|
| Rate for Payer: Vantage Medical Group Senior |
$12.41
|
|
|
HC SUTURE SILK #2, 60" 116183
|
Facility
|
IP
|
$13.94
|
|
| Hospital Charge Code |
901694661
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.79 |
| Max. Negotiated Rate |
$12.55 |
| Rate for Payer: Adventist Health Commercial |
$2.79
|
| Rate for Payer: Cash Price |
$6.27
|
| Rate for Payer: Central Health Plan Commercial |
$11.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.58
|
| Rate for Payer: Galaxy Health WC |
$11.85
|
| Rate for Payer: Global Benefits Group Commercial |
$8.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.79
|
| Rate for Payer: Multiplan Commercial |
$10.46
|
| Rate for Payer: Networks By Design Commercial |
$9.06
|
| Rate for Payer: Prime Health Services Commercial |
$11.85
|
|
