|
HC SUTURE CHROMIC GUT 6-0 18"
|
Facility
OP
|
$123.58
|
|
| Hospital Charge Code |
901601295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.72 |
| Max. Negotiated Rate |
$111.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$75.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$105.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$67.97
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$67.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$59.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$73.01
|
| Rate for Payer: BCBS Transplant Transplant |
$74.15
|
| Rate for Payer: Blue Shield of California Commercial |
$77.73
|
| Rate for Payer: Blue Shield of California EPN |
$60.43
|
| Rate for Payer: Cash Price |
$55.61
|
| Rate for Payer: Central Health Plan Commercial |
$98.86
|
| Rate for Payer: Cigna of CA HMO |
$79.09
|
| Rate for Payer: Cigna of CA PPO |
$91.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$105.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$49.43
|
| Rate for Payer: Galaxy Health WC |
$105.04
|
| Rate for Payer: Global Benefits Group Commercial |
$74.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$111.22
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$92.68
|
| Rate for Payer: IEHP medi-cal |
$43.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.72
|
| Rate for Payer: Multiplan Commercial |
$92.68
|
| Rate for Payer: Networks By Design Commercial |
$80.33
|
| Rate for Payer: Prime Health Services Commercial |
$105.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$74.15
|
| Rate for Payer: Riverside University Health MISP |
$49.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$74.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$74.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$61.79
|
| Rate for Payer: United Healthcare All Other HMO |
$61.79
|
| Rate for Payer: United Healthcare HMO Rider |
$61.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$61.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$105.04
|
| Rate for Payer: Vantage Medical Group Senior |
$105.04
|
|
|
HC SUTURE CHROMIC GUT 6-0 18"
|
Facility
IP
|
$123.58
|
|
| Hospital Charge Code |
901601295
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$24.72 |
| Max. Negotiated Rate |
$111.22 |
| Rate for Payer: Cash Price |
$55.61
|
| Rate for Payer: Central Health Plan Commercial |
$98.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.43
|
| Rate for Payer: Galaxy Health WC |
$105.04
|
| Rate for Payer: Global Benefits Group Commercial |
$74.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$111.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$82.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.72
|
| Rate for Payer: Multiplan Commercial |
$92.68
|
| Rate for Payer: Networks By Design Commercial |
$80.33
|
| Rate for Payer: Prime Health Services Commercial |
$105.04
|
|
|
HC SUTURE CHROMIC GUT SZ1 135721
|
Facility
OP
|
$22.96
|
|
| Hospital Charge Code |
901694626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.59 |
| Max. Negotiated Rate |
$20.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.56
|
| Rate for Payer: BCBS Transplant Transplant |
$13.78
|
| Rate for Payer: Blue Shield of California Commercial |
$14.44
|
| Rate for Payer: Blue Shield of California EPN |
$11.23
|
| Rate for Payer: Cash Price |
$10.33
|
| Rate for Payer: Central Health Plan Commercial |
$18.37
|
| Rate for Payer: Cigna of CA HMO |
$14.69
|
| Rate for Payer: Cigna of CA PPO |
$16.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.18
|
| Rate for Payer: Galaxy Health WC |
$19.52
|
| Rate for Payer: Global Benefits Group Commercial |
$13.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.66
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.22
|
| Rate for Payer: IEHP medi-cal |
$8.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.59
|
| Rate for Payer: Multiplan Commercial |
$17.22
|
| Rate for Payer: Networks By Design Commercial |
$14.92
|
| Rate for Payer: Prime Health Services Commercial |
$19.52
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.78
|
| Rate for Payer: Riverside University Health MISP |
$9.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.48
|
| Rate for Payer: United Healthcare All Other HMO |
$11.48
|
| Rate for Payer: United Healthcare HMO Rider |
$11.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.52
|
| Rate for Payer: Vantage Medical Group Senior |
$19.52
|
|
|
HC SUTURE CHROMIC GUT SZ1 135721
|
Facility
IP
|
$22.96
|
|
| Hospital Charge Code |
901694626
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.59 |
| Max. Negotiated Rate |
$20.66 |
| Rate for Payer: Cash Price |
$10.33
|
| Rate for Payer: Central Health Plan Commercial |
$18.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.18
|
| Rate for Payer: Galaxy Health WC |
$19.52
|
| Rate for Payer: Global Benefits Group Commercial |
$13.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.59
|
| Rate for Payer: Multiplan Commercial |
$17.22
|
| Rate for Payer: Networks By Design Commercial |
$14.92
|
| Rate for Payer: Prime Health Services Commercial |
$19.52
|
|
|
HC SUTURE CHROMIC O 27" 108242
|
Facility
IP
|
$71.34
|
|
| Hospital Charge Code |
901693101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.27 |
| Max. Negotiated Rate |
$64.21 |
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Central Health Plan Commercial |
$57.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.54
|
| Rate for Payer: Galaxy Health WC |
$60.64
|
| Rate for Payer: Global Benefits Group Commercial |
$42.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$64.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.27
|
| Rate for Payer: Multiplan Commercial |
$53.50
|
| Rate for Payer: Networks By Design Commercial |
$46.37
|
| Rate for Payer: Prime Health Services Commercial |
$60.64
|
|
|
HC SUTURE CHROMIC O 27" 108242
|
Facility
OP
|
$71.34
|
|
| Hospital Charge Code |
901693101
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.27 |
| Max. Negotiated Rate |
$64.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$43.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$60.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$39.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$39.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$34.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.15
|
| Rate for Payer: BCBS Transplant Transplant |
$42.80
|
| Rate for Payer: Blue Shield of California Commercial |
$44.87
|
| Rate for Payer: Blue Shield of California EPN |
$34.89
|
| Rate for Payer: Cash Price |
$32.10
|
| Rate for Payer: Central Health Plan Commercial |
$57.07
|
| Rate for Payer: Cigna of CA HMO |
$45.66
|
| Rate for Payer: Cigna of CA PPO |
$52.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$60.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$28.54
|
| Rate for Payer: Galaxy Health WC |
$60.64
|
| Rate for Payer: Global Benefits Group Commercial |
$42.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$64.21
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$53.50
|
| Rate for Payer: IEHP medi-cal |
$24.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$47.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.27
|
| Rate for Payer: Multiplan Commercial |
$53.50
|
| Rate for Payer: Networks By Design Commercial |
$46.37
|
| Rate for Payer: Prime Health Services Commercial |
$60.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$42.80
|
| Rate for Payer: Riverside University Health MISP |
$28.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$42.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$42.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$35.67
|
| Rate for Payer: United Healthcare All Other HMO |
$35.67
|
| Rate for Payer: United Healthcare HMO Rider |
$35.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$60.64
|
| Rate for Payer: Vantage Medical Group Senior |
$60.64
|
|
|
HC SUTURE DERMALON 3-0 18" C-14
|
Facility
OP
|
$51.66
|
|
| Hospital Charge Code |
901601298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.33 |
| Max. Negotiated Rate |
$46.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31.37
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$43.91
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$28.41
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$28.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.52
|
| Rate for Payer: BCBS Transplant Transplant |
$31.00
|
| Rate for Payer: Blue Shield of California Commercial |
$32.49
|
| Rate for Payer: Blue Shield of California EPN |
$25.26
|
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: Central Health Plan Commercial |
$41.33
|
| Rate for Payer: Cigna of CA HMO |
$33.06
|
| Rate for Payer: Cigna of CA PPO |
$38.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.66
|
| Rate for Payer: Galaxy Health WC |
$43.91
|
| Rate for Payer: Global Benefits Group Commercial |
$31.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.49
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$38.74
|
| Rate for Payer: IEHP medi-cal |
$18.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.33
|
| Rate for Payer: Multiplan Commercial |
$38.74
|
| Rate for Payer: Networks By Design Commercial |
$33.58
|
| Rate for Payer: Prime Health Services Commercial |
$43.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$31.00
|
| Rate for Payer: Riverside University Health MISP |
$20.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.83
|
| Rate for Payer: United Healthcare All Other HMO |
$25.83
|
| Rate for Payer: United Healthcare HMO Rider |
$25.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.91
|
| Rate for Payer: Vantage Medical Group Senior |
$43.91
|
|
|
HC SUTURE DERMALON 3-0 18" C-14
|
Facility
IP
|
$51.66
|
|
| Hospital Charge Code |
901601298
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.33 |
| Max. Negotiated Rate |
$46.49 |
| Rate for Payer: Cash Price |
$23.25
|
| Rate for Payer: Central Health Plan Commercial |
$41.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.66
|
| Rate for Payer: Galaxy Health WC |
$43.91
|
| Rate for Payer: Global Benefits Group Commercial |
$31.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.33
|
| Rate for Payer: Multiplan Commercial |
$38.74
|
| Rate for Payer: Networks By Design Commercial |
$33.58
|
| Rate for Payer: Prime Health Services Commercial |
$43.91
|
|
|
HC SUTURE ETHILON 2-0 18" FS
|
Facility
IP
|
$12.79
|
|
| Hospital Charge Code |
901604105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$11.51 |
| Rate for Payer: Cash Price |
$5.76
|
| Rate for Payer: Central Health Plan Commercial |
$10.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.12
|
| Rate for Payer: Galaxy Health WC |
$10.87
|
| Rate for Payer: Global Benefits Group Commercial |
$7.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.56
|
| Rate for Payer: Multiplan Commercial |
$9.59
|
| Rate for Payer: Networks By Design Commercial |
$8.31
|
| Rate for Payer: Prime Health Services Commercial |
$10.87
|
|
|
HC SUTURE ETHILON 2-0 18" FS
|
Facility
OP
|
$12.79
|
|
| Hospital Charge Code |
901604105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.56 |
| Max. Negotiated Rate |
$11.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.87
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.03
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.56
|
| Rate for Payer: BCBS Transplant Transplant |
$7.67
|
| Rate for Payer: Blue Shield of California Commercial |
$8.04
|
| Rate for Payer: Blue Shield of California EPN |
$6.25
|
| Rate for Payer: Cash Price |
$5.76
|
| Rate for Payer: Central Health Plan Commercial |
$10.23
|
| Rate for Payer: Cigna of CA HMO |
$8.19
|
| Rate for Payer: Cigna of CA PPO |
$9.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.12
|
| Rate for Payer: Galaxy Health WC |
$10.87
|
| Rate for Payer: Global Benefits Group Commercial |
$7.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.51
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.59
|
| Rate for Payer: IEHP medi-cal |
$4.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.56
|
| Rate for Payer: Multiplan Commercial |
$9.59
|
| Rate for Payer: Networks By Design Commercial |
$8.31
|
| Rate for Payer: Prime Health Services Commercial |
$10.87
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.67
|
| Rate for Payer: Riverside University Health MISP |
$5.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.40
|
| Rate for Payer: United Healthcare All Other HMO |
$6.40
|
| Rate for Payer: United Healthcare HMO Rider |
$6.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.87
|
| Rate for Payer: Vantage Medical Group Senior |
$10.87
|
|
|
HC SUTURE ETHILON 3-0 18" PS-1
|
Facility
IP
|
$25.17
|
|
| Hospital Charge Code |
901604016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Central Health Plan Commercial |
$20.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.07
|
| Rate for Payer: Galaxy Health WC |
$21.39
|
| Rate for Payer: Global Benefits Group Commercial |
$15.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.03
|
| Rate for Payer: Multiplan Commercial |
$18.88
|
| Rate for Payer: Networks By Design Commercial |
$16.36
|
| Rate for Payer: Prime Health Services Commercial |
$21.39
|
|
|
HC SUTURE ETHILON 3-0 18" PS-1
|
Facility
OP
|
$25.17
|
|
| Hospital Charge Code |
901604016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.84
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.87
|
| Rate for Payer: BCBS Transplant Transplant |
$15.10
|
| Rate for Payer: Blue Shield of California Commercial |
$15.83
|
| Rate for Payer: Blue Shield of California EPN |
$12.31
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Central Health Plan Commercial |
$20.14
|
| Rate for Payer: Cigna of CA HMO |
$16.11
|
| Rate for Payer: Cigna of CA PPO |
$18.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.07
|
| Rate for Payer: Galaxy Health WC |
$21.39
|
| Rate for Payer: Global Benefits Group Commercial |
$15.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.65
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.88
|
| Rate for Payer: IEHP medi-cal |
$8.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.03
|
| Rate for Payer: Multiplan Commercial |
$18.88
|
| Rate for Payer: Networks By Design Commercial |
$16.36
|
| Rate for Payer: Prime Health Services Commercial |
$21.39
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.10
|
| Rate for Payer: Riverside University Health MISP |
$10.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.58
|
| Rate for Payer: United Healthcare All Other HMO |
$12.58
|
| Rate for Payer: United Healthcare HMO Rider |
$12.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.39
|
| Rate for Payer: Vantage Medical Group Senior |
$21.39
|
|
|
HC SUTURE ETHILON 4-0 18"
|
Facility
OP
|
$25.17
|
|
| Hospital Charge Code |
901603481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.84
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.87
|
| Rate for Payer: BCBS Transplant Transplant |
$15.10
|
| Rate for Payer: Blue Shield of California Commercial |
$15.83
|
| Rate for Payer: Blue Shield of California EPN |
$12.31
|
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Central Health Plan Commercial |
$20.14
|
| Rate for Payer: Cigna of CA HMO |
$16.11
|
| Rate for Payer: Cigna of CA PPO |
$18.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.07
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.07
|
| Rate for Payer: Galaxy Health WC |
$21.39
|
| Rate for Payer: Global Benefits Group Commercial |
$15.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.65
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.88
|
| Rate for Payer: IEHP medi-cal |
$8.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.03
|
| Rate for Payer: Multiplan Commercial |
$18.88
|
| Rate for Payer: Networks By Design Commercial |
$16.36
|
| Rate for Payer: Prime Health Services Commercial |
$21.39
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$15.10
|
| Rate for Payer: Riverside University Health MISP |
$10.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.58
|
| Rate for Payer: United Healthcare All Other HMO |
$12.58
|
| Rate for Payer: United Healthcare HMO Rider |
$12.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.39
|
| Rate for Payer: Vantage Medical Group Senior |
$21.39
|
|
|
HC SUTURE ETHILON 4-0 18"
|
Facility
IP
|
$25.17
|
|
| Hospital Charge Code |
901603481
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.03 |
| Max. Negotiated Rate |
$22.65 |
| Rate for Payer: Cash Price |
$11.33
|
| Rate for Payer: Central Health Plan Commercial |
$20.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.07
|
| Rate for Payer: Galaxy Health WC |
$21.39
|
| Rate for Payer: Global Benefits Group Commercial |
$15.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.03
|
| Rate for Payer: Multiplan Commercial |
$18.88
|
| Rate for Payer: Networks By Design Commercial |
$16.36
|
| Rate for Payer: Prime Health Services Commercial |
$21.39
|
|
|
HC SUTURE ETHILON 4-0 18" P-3
|
Facility
OP
|
$28.37
|
|
| Hospital Charge Code |
901603977
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$25.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.76
|
| Rate for Payer: BCBS Transplant Transplant |
$17.02
|
| Rate for Payer: Blue Shield of California Commercial |
$17.84
|
| Rate for Payer: Blue Shield of California EPN |
$13.87
|
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Central Health Plan Commercial |
$22.70
|
| Rate for Payer: Cigna of CA HMO |
$18.16
|
| Rate for Payer: Cigna of CA PPO |
$20.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.35
|
| Rate for Payer: Galaxy Health WC |
$24.11
|
| Rate for Payer: Global Benefits Group Commercial |
$17.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.53
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21.28
|
| Rate for Payer: IEHP medi-cal |
$9.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.67
|
| Rate for Payer: Multiplan Commercial |
$21.28
|
| Rate for Payer: Networks By Design Commercial |
$18.44
|
| Rate for Payer: Prime Health Services Commercial |
$24.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.02
|
| Rate for Payer: Riverside University Health MISP |
$11.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.18
|
| Rate for Payer: United Healthcare All Other HMO |
$14.18
|
| Rate for Payer: United Healthcare HMO Rider |
$14.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.11
|
| Rate for Payer: Vantage Medical Group Senior |
$24.11
|
|
|
HC SUTURE ETHILON 4-0 18" P-3
|
Facility
IP
|
$28.37
|
|
| Hospital Charge Code |
901603977
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$25.53 |
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Central Health Plan Commercial |
$22.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.35
|
| Rate for Payer: Galaxy Health WC |
$24.11
|
| Rate for Payer: Global Benefits Group Commercial |
$17.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.67
|
| Rate for Payer: Multiplan Commercial |
$21.28
|
| Rate for Payer: Networks By Design Commercial |
$18.44
|
| Rate for Payer: Prime Health Services Commercial |
$24.11
|
|
|
HC SUTURE ETHILON 4-0 18" PC-1
|
Facility
IP
|
$29.68
|
|
| Hospital Charge Code |
901601299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$26.71 |
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Central Health Plan Commercial |
$23.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.87
|
| Rate for Payer: Galaxy Health WC |
$25.23
|
| Rate for Payer: Global Benefits Group Commercial |
$17.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.94
|
| Rate for Payer: Multiplan Commercial |
$22.26
|
| Rate for Payer: Networks By Design Commercial |
$19.29
|
| Rate for Payer: Prime Health Services Commercial |
$25.23
|
|
|
HC SUTURE ETHILON 4-0 18" PC-1
|
Facility
OP
|
$29.68
|
|
| Hospital Charge Code |
901601299
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.94 |
| Max. Negotiated Rate |
$26.71 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.32
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.53
|
| Rate for Payer: BCBS Transplant Transplant |
$17.81
|
| Rate for Payer: Blue Shield of California Commercial |
$18.67
|
| Rate for Payer: Blue Shield of California EPN |
$14.51
|
| Rate for Payer: Cash Price |
$13.36
|
| Rate for Payer: Central Health Plan Commercial |
$23.74
|
| Rate for Payer: Cigna of CA HMO |
$19.00
|
| Rate for Payer: Cigna of CA PPO |
$21.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.87
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.87
|
| Rate for Payer: Galaxy Health WC |
$25.23
|
| Rate for Payer: Global Benefits Group Commercial |
$17.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.71
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.26
|
| Rate for Payer: IEHP medi-cal |
$10.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.94
|
| Rate for Payer: Multiplan Commercial |
$22.26
|
| Rate for Payer: Networks By Design Commercial |
$19.29
|
| Rate for Payer: Prime Health Services Commercial |
$25.23
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.81
|
| Rate for Payer: Riverside University Health MISP |
$11.87
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.84
|
| Rate for Payer: United Healthcare All Other HMO |
$14.84
|
| Rate for Payer: United Healthcare HMO Rider |
$14.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.23
|
| Rate for Payer: Vantage Medical Group Senior |
$25.23
|
|
|
HC SUTURE ETHILON 4-0 18" PC-5
|
Facility
OP
|
$29.93
|
|
| Hospital Charge Code |
901604015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$26.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.46
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
| Rate for Payer: BCBS Transplant Transplant |
$17.96
|
| Rate for Payer: Blue Shield of California Commercial |
$18.83
|
| Rate for Payer: Blue Shield of California EPN |
$14.64
|
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Central Health Plan Commercial |
$23.94
|
| Rate for Payer: Cigna of CA HMO |
$19.16
|
| Rate for Payer: Cigna of CA PPO |
$22.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.94
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.45
|
| Rate for Payer: IEHP medi-cal |
$10.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.99
|
| Rate for Payer: Multiplan Commercial |
$22.45
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.96
|
| Rate for Payer: Riverside University Health MISP |
$11.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.96
|
| Rate for Payer: United Healthcare All Other HMO |
$14.96
|
| Rate for Payer: United Healthcare HMO Rider |
$14.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.44
|
| Rate for Payer: Vantage Medical Group Senior |
$25.44
|
|
|
HC SUTURE ETHILON 4-0 18" PC-5
|
Facility
IP
|
$29.93
|
|
| Hospital Charge Code |
901604015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$26.94 |
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Central Health Plan Commercial |
$23.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.99
|
| Rate for Payer: Multiplan Commercial |
$22.45
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
|
|
HC SUTURE ETHILON 4-0 18" PS-4
|
Facility
IP
|
$27.06
|
|
| Hospital Charge Code |
901601309
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$24.35 |
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Central Health Plan Commercial |
$21.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.82
|
| Rate for Payer: Galaxy Health WC |
$23.00
|
| Rate for Payer: Global Benefits Group Commercial |
$16.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.41
|
| Rate for Payer: Multiplan Commercial |
$20.30
|
| Rate for Payer: Networks By Design Commercial |
$17.59
|
| Rate for Payer: Prime Health Services Commercial |
$23.00
|
|
|
HC SUTURE ETHILON 4-0 18" PS-4
|
Facility
OP
|
$27.06
|
|
| Hospital Charge Code |
901601309
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.41 |
| Max. Negotiated Rate |
$24.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23.00
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.88
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.99
|
| Rate for Payer: BCBS Transplant Transplant |
$16.24
|
| Rate for Payer: Blue Shield of California Commercial |
$17.02
|
| Rate for Payer: Blue Shield of California EPN |
$13.23
|
| Rate for Payer: Cash Price |
$12.18
|
| Rate for Payer: Central Health Plan Commercial |
$21.65
|
| Rate for Payer: Cigna of CA HMO |
$17.32
|
| Rate for Payer: Cigna of CA PPO |
$20.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$10.82
|
| Rate for Payer: Galaxy Health WC |
$23.00
|
| Rate for Payer: Global Benefits Group Commercial |
$16.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.35
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20.30
|
| Rate for Payer: IEHP medi-cal |
$9.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.41
|
| Rate for Payer: Multiplan Commercial |
$20.30
|
| Rate for Payer: Networks By Design Commercial |
$17.59
|
| Rate for Payer: Prime Health Services Commercial |
$23.00
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16.24
|
| Rate for Payer: Riverside University Health MISP |
$10.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.53
|
| Rate for Payer: United Healthcare All Other HMO |
$13.53
|
| Rate for Payer: United Healthcare HMO Rider |
$13.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.00
|
| Rate for Payer: Vantage Medical Group Senior |
$23.00
|
|
|
HC SUTURE ETHILON 5-0 18" P-3
|
Facility
IP
|
$24.76
|
|
| Hospital Charge Code |
901600387
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$22.28 |
| Rate for Payer: Cash Price |
$11.14
|
| Rate for Payer: Central Health Plan Commercial |
$19.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$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 Permanente of CA Commercial/Self Funded |
$16.51
|
| 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 ETHILON 5-0 18" P-3
|
Facility
OP
|
$24.76
|
|
| Hospital Charge Code |
901600387
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.95 |
| Max. Negotiated Rate |
$22.28 |
| Rate for Payer: Aetna of CA HMO/PPO |
$15.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$21.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.63
|
| Rate for Payer: BCBS Transplant Transplant |
$14.86
|
| Rate for Payer: Blue Shield of California Commercial |
$15.57
|
| Rate for Payer: Blue Shield of California EPN |
$12.11
|
| 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: EPIC Health Plan Commercial |
$9.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$18.57
|
| Rate for Payer: IEHP medi-cal |
$8.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.51
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.86
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$21.05
|
| Rate for Payer: Vantage Medical Group Senior |
$21.05
|
|
|
HC SUTURE ETHILON 5-0 18" P3
|
Facility
OP
|
$29.93
|
|
| Hospital Charge Code |
901604014
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$26.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.46
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
| Rate for Payer: BCBS Transplant Transplant |
$17.96
|
| Rate for Payer: Blue Shield of California Commercial |
$18.83
|
| Rate for Payer: Blue Shield of California EPN |
$14.64
|
| Rate for Payer: Cash Price |
$13.47
|
| Rate for Payer: Central Health Plan Commercial |
$23.94
|
| Rate for Payer: Cigna of CA HMO |
$19.16
|
| Rate for Payer: Cigna of CA PPO |
$22.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.94
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.45
|
| Rate for Payer: IEHP medi-cal |
$10.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.99
|
| Rate for Payer: Multiplan Commercial |
$22.45
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.96
|
| Rate for Payer: Riverside University Health MISP |
$11.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.96
|
| Rate for Payer: United Healthcare All Other HMO |
$14.96
|
| Rate for Payer: United Healthcare HMO Rider |
$14.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.44
|
| Rate for Payer: Vantage Medical Group Senior |
$25.44
|
|
