|
HC SUTURE CHROMIC 3-0 27" CT-1
|
Facility
OP
|
$20.75
|
|
| Hospital Charge Code |
901602881
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.15 |
| Max. Negotiated Rate |
$18.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.41
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.26
|
| Rate for Payer: BCBS Transplant Transplant |
$12.45
|
| Rate for Payer: Blue Shield of California Commercial |
$13.05
|
| Rate for Payer: Blue Shield of California EPN |
$10.15
|
| Rate for Payer: Cash Price |
$9.34
|
| Rate for Payer: Central Health Plan Commercial |
$16.60
|
| Rate for Payer: Cigna of CA HMO |
$13.28
|
| Rate for Payer: Cigna of CA PPO |
$15.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.30
|
| Rate for Payer: Galaxy Health WC |
$17.64
|
| Rate for Payer: Global Benefits Group Commercial |
$12.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.68
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.56
|
| Rate for Payer: IEHP medi-cal |
$7.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.15
|
| Rate for Payer: Multiplan Commercial |
$15.56
|
| Rate for Payer: Networks By Design Commercial |
$13.49
|
| Rate for Payer: Prime Health Services Commercial |
$17.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.45
|
| Rate for Payer: Riverside University Health MISP |
$8.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.38
|
| Rate for Payer: United Healthcare All Other HMO |
$10.38
|
| Rate for Payer: United Healthcare HMO Rider |
$10.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.64
|
| Rate for Payer: Vantage Medical Group Senior |
$17.64
|
|
|
HC SUTURE CHROMIC 3-0 CT2 104504
|
Facility
OP
|
$21.16
|
|
| Hospital Charge Code |
901694620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$19.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.99
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.64
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.50
|
| Rate for Payer: BCBS Transplant Transplant |
$12.70
|
| Rate for Payer: Blue Shield of California Commercial |
$13.31
|
| Rate for Payer: Blue Shield of California EPN |
$10.35
|
| Rate for Payer: Cash Price |
$9.52
|
| Rate for Payer: Central Health Plan Commercial |
$16.93
|
| Rate for Payer: Cigna of CA HMO |
$13.54
|
| Rate for Payer: Cigna of CA PPO |
$15.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.46
|
| Rate for Payer: Galaxy Health WC |
$17.99
|
| Rate for Payer: Global Benefits Group Commercial |
$12.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.04
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.87
|
| Rate for Payer: IEHP medi-cal |
$7.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.23
|
| Rate for Payer: Multiplan Commercial |
$15.87
|
| Rate for Payer: Networks By Design Commercial |
$13.75
|
| Rate for Payer: Prime Health Services Commercial |
$17.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.70
|
| Rate for Payer: Riverside University Health MISP |
$8.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.58
|
| Rate for Payer: United Healthcare All Other HMO |
$10.58
|
| Rate for Payer: United Healthcare HMO Rider |
$10.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.99
|
| Rate for Payer: Vantage Medical Group Senior |
$17.99
|
|
|
HC SUTURE CHROMIC 3-0 CT2 104504
|
Facility
IP
|
$21.16
|
|
| Hospital Charge Code |
901694620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$19.04 |
| Rate for Payer: Cash Price |
$9.52
|
| Rate for Payer: Central Health Plan Commercial |
$16.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.46
|
| Rate for Payer: Galaxy Health WC |
$17.99
|
| Rate for Payer: Global Benefits Group Commercial |
$12.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.23
|
| Rate for Payer: Multiplan Commercial |
$15.87
|
| Rate for Payer: Networks By Design Commercial |
$13.75
|
| Rate for Payer: Prime Health Services Commercial |
$17.99
|
|
|
HC SUTURE CHROMIC 4-0 PS-2
|
Facility
OP
|
$47.89
|
|
| Hospital Charge Code |
901694888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$43.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29.08
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$40.71
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$26.34
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$26.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.29
|
| Rate for Payer: BCBS Transplant Transplant |
$28.73
|
| Rate for Payer: Blue Shield of California Commercial |
$30.12
|
| Rate for Payer: Blue Shield of California EPN |
$23.42
|
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Central Health Plan Commercial |
$38.31
|
| Rate for Payer: Cigna of CA HMO |
$30.65
|
| Rate for Payer: Cigna of CA PPO |
$35.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$19.16
|
| Rate for Payer: Galaxy Health WC |
$40.71
|
| Rate for Payer: Global Benefits Group Commercial |
$28.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$35.92
|
| Rate for Payer: IEHP medi-cal |
$16.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.58
|
| Rate for Payer: Multiplan Commercial |
$35.92
|
| Rate for Payer: Networks By Design Commercial |
$31.13
|
| Rate for Payer: Prime Health Services Commercial |
$40.71
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$28.73
|
| Rate for Payer: Riverside University Health MISP |
$19.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$23.94
|
| Rate for Payer: United Healthcare All Other HMO |
$23.94
|
| Rate for Payer: United Healthcare HMO Rider |
$23.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$23.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.71
|
| Rate for Payer: Vantage Medical Group Senior |
$40.71
|
|
|
HC SUTURE CHROMIC 4-0 PS-2
|
Facility
IP
|
$47.89
|
|
| Hospital Charge Code |
901694888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.58 |
| Max. Negotiated Rate |
$43.10 |
| Rate for Payer: Cash Price |
$21.55
|
| Rate for Payer: Central Health Plan Commercial |
$38.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.16
|
| Rate for Payer: Galaxy Health WC |
$40.71
|
| Rate for Payer: Global Benefits Group Commercial |
$28.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$31.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.58
|
| Rate for Payer: Multiplan Commercial |
$35.92
|
| Rate for Payer: Networks By Design Commercial |
$31.13
|
| Rate for Payer: Prime Health Services Commercial |
$40.71
|
|
|
HC SUTURE CHROMIC CT-2 100063
|
Facility
IP
|
$21.24
|
|
| Hospital Charge Code |
901694627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Central Health Plan Commercial |
$16.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Multiplan Commercial |
$15.93
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
|
|
HC SUTURE CHROMIC CT-2 100063
|
Facility
OP
|
$21.24
|
|
| Hospital Charge Code |
901694627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.68
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.55
|
| Rate for Payer: BCBS Transplant Transplant |
$12.74
|
| Rate for Payer: Blue Shield of California Commercial |
$13.36
|
| Rate for Payer: Blue Shield of California EPN |
$10.39
|
| Rate for Payer: Cash Price |
$9.56
|
| Rate for Payer: Central Health Plan Commercial |
$16.99
|
| Rate for Payer: Cigna of CA HMO |
$13.59
|
| Rate for Payer: Cigna of CA PPO |
$15.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.12
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.93
|
| Rate for Payer: IEHP medi-cal |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Multiplan Commercial |
$15.93
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.74
|
| Rate for Payer: Riverside University Health MISP |
$8.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.62
|
| Rate for Payer: United Healthcare All Other HMO |
$10.62
|
| Rate for Payer: United Healthcare HMO Rider |
$10.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.05
|
| Rate for Payer: Vantage Medical Group Senior |
$18.05
|
|
|
HC SUTURE CHROMIC GUT 0 102839
|
Facility
OP
|
$21.81
|
|
| Hospital Charge Code |
901694631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$19.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.25
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.89
|
| Rate for Payer: BCBS Transplant Transplant |
$13.09
|
| Rate for Payer: Blue Shield of California Commercial |
$13.72
|
| Rate for Payer: Blue Shield of California EPN |
$10.67
|
| Rate for Payer: Cash Price |
$9.81
|
| Rate for Payer: Central Health Plan Commercial |
$17.45
|
| Rate for Payer: Cigna of CA HMO |
$13.96
|
| Rate for Payer: Cigna of CA PPO |
$16.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.72
|
| Rate for Payer: Galaxy Health WC |
$18.54
|
| Rate for Payer: Global Benefits Group Commercial |
$13.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.63
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$16.36
|
| Rate for Payer: IEHP medi-cal |
$7.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.36
|
| Rate for Payer: Multiplan Commercial |
$16.36
|
| Rate for Payer: Networks By Design Commercial |
$14.18
|
| Rate for Payer: Prime Health Services Commercial |
$18.54
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.09
|
| Rate for Payer: Riverside University Health MISP |
$8.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.90
|
| Rate for Payer: United Healthcare All Other HMO |
$10.90
|
| Rate for Payer: United Healthcare HMO Rider |
$10.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.54
|
| Rate for Payer: Vantage Medical Group Senior |
$18.54
|
|
|
HC SUTURE CHROMIC GUT 0 102839
|
Facility
IP
|
$21.81
|
|
| Hospital Charge Code |
901694631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.36 |
| Max. Negotiated Rate |
$19.63 |
| Rate for Payer: Cash Price |
$9.81
|
| Rate for Payer: Central Health Plan Commercial |
$17.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.72
|
| Rate for Payer: Galaxy Health WC |
$18.54
|
| Rate for Payer: Global Benefits Group Commercial |
$13.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.36
|
| Rate for Payer: Multiplan Commercial |
$16.36
|
| Rate for Payer: Networks By Design Commercial |
$14.18
|
| Rate for Payer: Prime Health Services Commercial |
$18.54
|
|
|
HC SUTURE CHROMIC GUT 0 113342
|
Facility
OP
|
$26.97
|
|
| Hospital Charge Code |
901694612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.93
|
| Rate for Payer: BCBS Transplant Transplant |
$16.18
|
| Rate for Payer: Blue Shield of California Commercial |
$16.96
|
| Rate for Payer: Blue Shield of California EPN |
$13.19
|
| Rate for Payer: Cash Price |
$12.14
|
| Rate for Payer: Central Health Plan Commercial |
$21.58
|
| Rate for Payer: Cigna of CA HMO |
$17.26
|
| Rate for Payer: Cigna of CA PPO |
$19.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.79
|
| Rate for Payer: Galaxy Health WC |
$22.92
|
| Rate for Payer: Global Benefits Group Commercial |
$16.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.27
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20.23
|
| Rate for Payer: IEHP medi-cal |
$9.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$20.23
|
| Rate for Payer: Networks By Design Commercial |
$17.53
|
| Rate for Payer: Prime Health Services Commercial |
$22.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16.18
|
| Rate for Payer: Riverside University Health MISP |
$10.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.48
|
| Rate for Payer: United Healthcare All Other HMO |
$13.48
|
| Rate for Payer: United Healthcare HMO Rider |
$13.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.92
|
| Rate for Payer: Vantage Medical Group Senior |
$22.92
|
|
|
HC SUTURE CHROMIC GUT 0 113342
|
Facility
IP
|
$26.97
|
|
| Hospital Charge Code |
901694612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Cash Price |
$12.14
|
| Rate for Payer: Central Health Plan Commercial |
$21.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.79
|
| Rate for Payer: Galaxy Health WC |
$22.92
|
| Rate for Payer: Global Benefits Group Commercial |
$16.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$20.23
|
| Rate for Payer: Networks By Design Commercial |
$17.53
|
| Rate for Payer: Prime Health Services Commercial |
$22.92
|
|
|
HC SUTURE CHROMIC GUT 0 18"210353
|
Facility
OP
|
$179.06
|
|
| Hospital Charge Code |
901693102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$161.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$108.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$152.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$98.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$98.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$86.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.79
|
| Rate for Payer: BCBS Transplant Transplant |
$107.44
|
| Rate for Payer: Blue Shield of California Commercial |
$112.63
|
| Rate for Payer: Blue Shield of California EPN |
$87.56
|
| Rate for Payer: Cash Price |
$80.58
|
| Rate for Payer: Central Health Plan Commercial |
$143.25
|
| Rate for Payer: Cigna of CA HMO |
$114.60
|
| Rate for Payer: Cigna of CA PPO |
$132.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$152.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$71.62
|
| Rate for Payer: Galaxy Health WC |
$152.20
|
| Rate for Payer: Global Benefits Group Commercial |
$107.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.15
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$134.30
|
| Rate for Payer: IEHP medi-cal |
$62.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.81
|
| Rate for Payer: Multiplan Commercial |
$134.30
|
| Rate for Payer: Networks By Design Commercial |
$116.39
|
| Rate for Payer: Prime Health Services Commercial |
$152.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$107.44
|
| Rate for Payer: Riverside University Health MISP |
$71.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$89.53
|
| Rate for Payer: United Healthcare All Other HMO |
$89.53
|
| Rate for Payer: United Healthcare HMO Rider |
$89.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$89.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$152.20
|
| Rate for Payer: Vantage Medical Group Senior |
$152.20
|
|
|
HC SUTURE CHROMIC GUT 0 18"210353
|
Facility
IP
|
$179.06
|
|
| Hospital Charge Code |
901693102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$161.15 |
| Rate for Payer: Cash Price |
$80.58
|
| Rate for Payer: Central Health Plan Commercial |
$143.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.62
|
| Rate for Payer: Galaxy Health WC |
$152.20
|
| Rate for Payer: Global Benefits Group Commercial |
$107.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.81
|
| Rate for Payer: Multiplan Commercial |
$134.30
|
| Rate for Payer: Networks By Design Commercial |
$116.39
|
| Rate for Payer: Prime Health Services Commercial |
$152.20
|
|
|
HC SUTURE CHROMIC GUT 1-0 105493
|
Facility
IP
|
$24.19
|
|
| Hospital Charge Code |
901694864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$21.77 |
| Rate for Payer: Cash Price |
$10.89
|
| Rate for Payer: Central Health Plan Commercial |
$19.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.68
|
| Rate for Payer: Galaxy Health WC |
$20.56
|
| Rate for Payer: Global Benefits Group Commercial |
$14.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.84
|
| Rate for Payer: Multiplan Commercial |
$18.14
|
| Rate for Payer: Networks By Design Commercial |
$15.72
|
| Rate for Payer: Prime Health Services Commercial |
$20.56
|
|
|
HC SUTURE CHROMIC GUT 1-0 105493
|
Facility
OP
|
$24.19
|
|
| Hospital Charge Code |
901694864
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.84 |
| Max. Negotiated Rate |
$21.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.71
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.29
|
| Rate for Payer: BCBS Transplant Transplant |
$14.51
|
| Rate for Payer: Blue Shield of California Commercial |
$15.22
|
| Rate for Payer: Blue Shield of California EPN |
$11.83
|
| Rate for Payer: Cash Price |
$10.89
|
| Rate for Payer: Central Health Plan Commercial |
$19.35
|
| Rate for Payer: Cigna of CA HMO |
$15.48
|
| Rate for Payer: Cigna of CA PPO |
$17.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.68
|
| Rate for Payer: Galaxy Health WC |
$20.56
|
| Rate for Payer: Global Benefits Group Commercial |
$14.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.77
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.14
|
| Rate for Payer: IEHP medi-cal |
$8.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.84
|
| Rate for Payer: Multiplan Commercial |
$18.14
|
| Rate for Payer: Networks By Design Commercial |
$15.72
|
| Rate for Payer: Prime Health Services Commercial |
$20.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.51
|
| Rate for Payer: Riverside University Health MISP |
$9.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.10
|
| Rate for Payer: United Healthcare All Other HMO |
$12.10
|
| Rate for Payer: United Healthcare HMO Rider |
$12.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.56
|
| Rate for Payer: Vantage Medical Group Senior |
$20.56
|
|
|
HC SUTURE CHROMIC GUT 1-0 105628
|
Facility
IP
|
$188.16
|
|
| Hospital Charge Code |
901694865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.63 |
| Max. Negotiated Rate |
$169.34 |
| Rate for Payer: Cash Price |
$84.67
|
| Rate for Payer: Central Health Plan Commercial |
$150.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.26
|
| Rate for Payer: Galaxy Health WC |
$159.94
|
| Rate for Payer: Global Benefits Group Commercial |
$112.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$169.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$125.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.63
|
| Rate for Payer: Multiplan Commercial |
$141.12
|
| Rate for Payer: Networks By Design Commercial |
$122.30
|
| Rate for Payer: Prime Health Services Commercial |
$159.94
|
|
|
HC SUTURE CHROMIC GUT 1-0 105628
|
Facility
OP
|
$188.16
|
|
| Hospital Charge Code |
901694865
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$37.63 |
| Max. Negotiated Rate |
$169.34 |
| Rate for Payer: Aetna of CA HMO/PPO |
$114.27
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$159.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$103.49
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$103.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$91.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$111.16
|
| Rate for Payer: BCBS Transplant Transplant |
$112.90
|
| Rate for Payer: Blue Shield of California Commercial |
$118.35
|
| Rate for Payer: Blue Shield of California EPN |
$92.01
|
| Rate for Payer: Cash Price |
$84.67
|
| Rate for Payer: Central Health Plan Commercial |
$150.53
|
| Rate for Payer: Cigna of CA HMO |
$120.42
|
| Rate for Payer: Cigna of CA PPO |
$139.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$159.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$75.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$75.26
|
| Rate for Payer: Galaxy Health WC |
$159.94
|
| Rate for Payer: Global Benefits Group Commercial |
$112.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$169.34
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$141.12
|
| Rate for Payer: IEHP medi-cal |
$65.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$125.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$37.63
|
| Rate for Payer: Multiplan Commercial |
$141.12
|
| Rate for Payer: Networks By Design Commercial |
$122.30
|
| Rate for Payer: Prime Health Services Commercial |
$159.94
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$112.90
|
| Rate for Payer: Riverside University Health MISP |
$75.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$112.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$112.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$94.08
|
| Rate for Payer: United Healthcare All Other HMO |
$94.08
|
| Rate for Payer: United Healthcare HMO Rider |
$94.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$94.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$159.94
|
| Rate for Payer: Vantage Medical Group Senior |
$159.94
|
|
|
HC SUTURE CHROMIC GUT 2-0 G5-21
|
Facility
IP
|
$61.17
|
|
| Hospital Charge Code |
901698694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$55.05 |
| Rate for Payer: Cash Price |
$27.53
|
| Rate for Payer: Central Health Plan Commercial |
$48.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.47
|
| Rate for Payer: Galaxy Health WC |
$51.99
|
| Rate for Payer: Global Benefits Group Commercial |
$36.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.23
|
| Rate for Payer: Multiplan Commercial |
$45.88
|
| Rate for Payer: Networks By Design Commercial |
$39.76
|
| Rate for Payer: Prime Health Services Commercial |
$51.99
|
|
|
HC SUTURE CHROMIC GUT 2-0 G5-21
|
Facility
OP
|
$61.17
|
|
| Hospital Charge Code |
901698694
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.23 |
| Max. Negotiated Rate |
$55.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$37.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$51.99
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$33.64
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$33.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$36.14
|
| Rate for Payer: BCBS Transplant Transplant |
$36.70
|
| Rate for Payer: Blue Shield of California Commercial |
$38.48
|
| Rate for Payer: Blue Shield of California EPN |
$29.91
|
| Rate for Payer: Cash Price |
$27.53
|
| Rate for Payer: Central Health Plan Commercial |
$48.94
|
| Rate for Payer: Cigna of CA HMO |
$39.15
|
| Rate for Payer: Cigna of CA PPO |
$45.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$24.47
|
| Rate for Payer: Galaxy Health WC |
$51.99
|
| Rate for Payer: Global Benefits Group Commercial |
$36.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$55.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$45.88
|
| Rate for Payer: IEHP medi-cal |
$21.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.23
|
| Rate for Payer: Multiplan Commercial |
$45.88
|
| Rate for Payer: Networks By Design Commercial |
$39.76
|
| Rate for Payer: Prime Health Services Commercial |
$51.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$36.70
|
| Rate for Payer: Riverside University Health MISP |
$24.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.58
|
| Rate for Payer: United Healthcare All Other HMO |
$30.58
|
| Rate for Payer: United Healthcare HMO Rider |
$30.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.99
|
| Rate for Payer: Vantage Medical Group Senior |
$51.99
|
|
|
HC SUTURE CHROMIC GUT 4-0
|
Facility
IP
|
$20.25
|
|
| Hospital Charge Code |
901603479
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$18.22 |
| Rate for Payer: Cash Price |
$9.11
|
| Rate for Payer: Central Health Plan Commercial |
$16.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.10
|
| Rate for Payer: Galaxy Health WC |
$17.21
|
| Rate for Payer: Global Benefits Group Commercial |
$12.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.05
|
| Rate for Payer: Multiplan Commercial |
$15.19
|
| Rate for Payer: Networks By Design Commercial |
$13.16
|
| Rate for Payer: Prime Health Services Commercial |
$17.21
|
|
|
HC SUTURE CHROMIC GUT 4-0
|
Facility
OP
|
$20.25
|
|
| Hospital Charge Code |
901603479
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.05 |
| Max. Negotiated Rate |
$18.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$12.30
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$17.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$11.14
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$11.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.96
|
| Rate for Payer: BCBS Transplant Transplant |
$12.15
|
| Rate for Payer: Blue Shield of California Commercial |
$12.74
|
| Rate for Payer: Blue Shield of California EPN |
$9.90
|
| Rate for Payer: Cash Price |
$9.11
|
| Rate for Payer: Central Health Plan Commercial |
$16.20
|
| Rate for Payer: Cigna of CA HMO |
$12.96
|
| Rate for Payer: Cigna of CA PPO |
$14.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.10
|
| Rate for Payer: Galaxy Health WC |
$17.21
|
| Rate for Payer: Global Benefits Group Commercial |
$12.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$18.22
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$15.19
|
| Rate for Payer: IEHP medi-cal |
$7.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.05
|
| Rate for Payer: Multiplan Commercial |
$15.19
|
| Rate for Payer: Networks By Design Commercial |
$13.16
|
| Rate for Payer: Prime Health Services Commercial |
$17.21
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$12.15
|
| Rate for Payer: Riverside University Health MISP |
$8.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.12
|
| Rate for Payer: United Healthcare All Other HMO |
$10.12
|
| Rate for Payer: United Healthcare HMO Rider |
$10.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.21
|
| Rate for Payer: Vantage Medical Group Senior |
$17.21
|
|
|
HC SUTURE CHROMIC GUT 4-0 27"
|
Facility
OP
|
$22.30
|
|
| Hospital Charge Code |
901601293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$20.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$18.96
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.17
|
| Rate for Payer: BCBS Transplant Transplant |
$13.38
|
| Rate for Payer: Blue Shield of California Commercial |
$14.03
|
| Rate for Payer: Blue Shield of California EPN |
$10.90
|
| Rate for Payer: Cash Price |
$10.04
|
| Rate for Payer: Central Health Plan Commercial |
$17.84
|
| Rate for Payer: Cigna of CA HMO |
$14.27
|
| Rate for Payer: Cigna of CA PPO |
$16.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$8.92
|
| Rate for Payer: Galaxy Health WC |
$18.96
|
| Rate for Payer: Global Benefits Group Commercial |
$13.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.07
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$16.72
|
| Rate for Payer: IEHP medi-cal |
$7.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.46
|
| Rate for Payer: Multiplan Commercial |
$16.72
|
| Rate for Payer: Networks By Design Commercial |
$14.50
|
| Rate for Payer: Prime Health Services Commercial |
$18.96
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.38
|
| Rate for Payer: Riverside University Health MISP |
$8.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.15
|
| Rate for Payer: United Healthcare All Other HMO |
$11.15
|
| Rate for Payer: United Healthcare HMO Rider |
$11.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.96
|
| Rate for Payer: Vantage Medical Group Senior |
$18.96
|
|
|
HC SUTURE CHROMIC GUT 4-0 27"
|
Facility
IP
|
$22.30
|
|
| Hospital Charge Code |
901601293
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.46 |
| Max. Negotiated Rate |
$20.07 |
| Rate for Payer: Cash Price |
$10.04
|
| Rate for Payer: Central Health Plan Commercial |
$17.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.92
|
| Rate for Payer: Galaxy Health WC |
$18.96
|
| Rate for Payer: Global Benefits Group Commercial |
$13.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.46
|
| Rate for Payer: Multiplan Commercial |
$16.72
|
| Rate for Payer: Networks By Design Commercial |
$14.50
|
| Rate for Payer: Prime Health Services Commercial |
$18.96
|
|
|
HC SUTURE CHROMIC GUT 5-0 18"
|
Facility
OP
|
$41.90
|
|
| Hospital Charge Code |
901604111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$37.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$35.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.04
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$23.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.75
|
| Rate for Payer: BCBS Transplant Transplant |
$25.14
|
| Rate for Payer: Blue Shield of California Commercial |
$26.36
|
| Rate for Payer: Blue Shield of California EPN |
$20.49
|
| Rate for Payer: Cash Price |
$18.86
|
| Rate for Payer: Central Health Plan Commercial |
$33.52
|
| Rate for Payer: Cigna of CA HMO |
$26.82
|
| Rate for Payer: Cigna of CA PPO |
$31.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.76
|
| Rate for Payer: Galaxy Health WC |
$35.62
|
| Rate for Payer: Global Benefits Group Commercial |
$25.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.71
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$31.42
|
| Rate for Payer: IEHP medi-cal |
$14.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.38
|
| Rate for Payer: Multiplan Commercial |
$31.42
|
| Rate for Payer: Networks By Design Commercial |
$27.24
|
| Rate for Payer: Prime Health Services Commercial |
$35.62
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$25.14
|
| Rate for Payer: Riverside University Health MISP |
$16.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.95
|
| Rate for Payer: United Healthcare All Other HMO |
$20.95
|
| Rate for Payer: United Healthcare HMO Rider |
$20.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$35.62
|
| Rate for Payer: Vantage Medical Group Senior |
$35.62
|
|
|
HC SUTURE CHROMIC GUT 5-0 18"
|
Facility
IP
|
$41.90
|
|
| Hospital Charge Code |
901604111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.38 |
| Max. Negotiated Rate |
$37.71 |
| Rate for Payer: Cash Price |
$18.86
|
| Rate for Payer: Central Health Plan Commercial |
$33.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.76
|
| Rate for Payer: Galaxy Health WC |
$35.62
|
| Rate for Payer: Global Benefits Group Commercial |
$25.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.38
|
| Rate for Payer: Multiplan Commercial |
$31.42
|
| Rate for Payer: Networks By Design Commercial |
$27.24
|
| Rate for Payer: Prime Health Services Commercial |
$35.62
|
|
