|
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
|
|
|
HC SUTURE ETHILON 5-0 18" PS2
|
Facility
OP
|
$23.62
|
|
| Hospital Charge Code |
901600856
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$21.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.08
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.99
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.95
|
| Rate for Payer: BCBS Transplant Transplant |
$14.17
|
| Rate for Payer: Blue Shield of California Commercial |
$14.86
|
| Rate for Payer: Blue Shield of California EPN |
$11.55
|
| Rate for Payer: Cash Price |
$10.63
|
| Rate for Payer: Central Health Plan Commercial |
$18.90
|
| Rate for Payer: Cigna of CA HMO |
$15.12
|
| Rate for Payer: Cigna of CA PPO |
$17.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.45
|
| Rate for Payer: Galaxy Health WC |
$20.08
|
| Rate for Payer: Global Benefits Group Commercial |
$14.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.72
|
| Rate for Payer: IEHP medi-cal |
$8.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Multiplan Commercial |
$17.72
|
| Rate for Payer: Networks By Design Commercial |
$15.35
|
| Rate for Payer: Prime Health Services Commercial |
$20.08
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.17
|
| Rate for Payer: Riverside University Health MISP |
$9.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.81
|
| Rate for Payer: United Healthcare All Other HMO |
$11.81
|
| Rate for Payer: United Healthcare HMO Rider |
$11.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.08
|
| Rate for Payer: Vantage Medical Group Senior |
$20.08
|
|
|
HC SUTURE ETHILON 5-0 18" PS2
|
Facility
IP
|
$23.62
|
|
| Hospital Charge Code |
901600856
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$21.26 |
| Rate for Payer: Cash Price |
$10.63
|
| Rate for Payer: Central Health Plan Commercial |
$18.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.45
|
| Rate for Payer: Galaxy Health WC |
$20.08
|
| Rate for Payer: Global Benefits Group Commercial |
$14.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.72
|
| Rate for Payer: Multiplan Commercial |
$17.72
|
| Rate for Payer: Networks By Design Commercial |
$15.35
|
| Rate for Payer: Prime Health Services Commercial |
$20.08
|
|
|
HC SUTURE ETHILON 5-0 P-3
|
Facility
OP
|
$27.59
|
|
| Hospital Charge Code |
901691500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$24.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16.76
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.30
|
| Rate for Payer: BCBS Transplant Transplant |
$16.55
|
| Rate for Payer: Blue Shield of California Commercial |
$17.35
|
| Rate for Payer: Blue Shield of California EPN |
$13.49
|
| Rate for Payer: Cash Price |
$12.42
|
| Rate for Payer: Central Health Plan Commercial |
$22.07
|
| Rate for Payer: Cigna of CA HMO |
$17.66
|
| Rate for Payer: Cigna of CA PPO |
$20.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.04
|
| Rate for Payer: Galaxy Health WC |
$23.45
|
| Rate for Payer: Global Benefits Group Commercial |
$16.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$20.69
|
| Rate for Payer: IEHP medi-cal |
$9.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$20.69
|
| Rate for Payer: Networks By Design Commercial |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$23.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$16.55
|
| Rate for Payer: Riverside University Health MISP |
$11.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.80
|
| Rate for Payer: United Healthcare All Other HMO |
$13.80
|
| Rate for Payer: United Healthcare HMO Rider |
$13.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.45
|
| Rate for Payer: Vantage Medical Group Senior |
$23.45
|
|
|
HC SUTURE ETHILON 5-0 P-3
|
Facility
IP
|
$27.59
|
|
| Hospital Charge Code |
901691500
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.52 |
| Max. Negotiated Rate |
$24.83 |
| Rate for Payer: Cash Price |
$12.42
|
| Rate for Payer: Central Health Plan Commercial |
$22.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.04
|
| Rate for Payer: Galaxy Health WC |
$23.45
|
| Rate for Payer: Global Benefits Group Commercial |
$16.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$20.69
|
| Rate for Payer: Networks By Design Commercial |
$17.93
|
| Rate for Payer: Prime Health Services Commercial |
$23.45
|
|
|
HC SUTURE ETHILON 5-0 PC-1 12099
|
Facility
IP
|
$29.44
|
|
| Hospital Charge Code |
901694893
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$26.50 |
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Central Health Plan Commercial |
$23.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.78
|
| Rate for Payer: Galaxy Health WC |
$25.02
|
| Rate for Payer: Global Benefits Group Commercial |
$17.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.89
|
| Rate for Payer: Multiplan Commercial |
$22.08
|
| Rate for Payer: Networks By Design Commercial |
$19.14
|
| Rate for Payer: Prime Health Services Commercial |
$25.02
|
|
|
HC SUTURE ETHILON 5-0 PC-1 12099
|
Facility
OP
|
$29.44
|
|
| Hospital Charge Code |
901694893
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$26.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.19
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.19
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.39
|
| Rate for Payer: BCBS Transplant Transplant |
$17.66
|
| Rate for Payer: Blue Shield of California Commercial |
$18.52
|
| Rate for Payer: Blue Shield of California EPN |
$14.40
|
| Rate for Payer: Cash Price |
$13.25
|
| Rate for Payer: Central Health Plan Commercial |
$23.55
|
| Rate for Payer: Cigna of CA HMO |
$18.84
|
| Rate for Payer: Cigna of CA PPO |
$21.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.78
|
| Rate for Payer: Galaxy Health WC |
$25.02
|
| Rate for Payer: Global Benefits Group Commercial |
$17.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.08
|
| Rate for Payer: IEHP medi-cal |
$10.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.89
|
| Rate for Payer: Multiplan Commercial |
$22.08
|
| Rate for Payer: Networks By Design Commercial |
$19.14
|
| Rate for Payer: Prime Health Services Commercial |
$25.02
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.66
|
| Rate for Payer: Riverside University Health MISP |
$11.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.72
|
| Rate for Payer: United Healthcare All Other HMO |
$14.72
|
| Rate for Payer: United Healthcare HMO Rider |
$14.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.02
|
| Rate for Payer: Vantage Medical Group Senior |
$25.02
|
|
|
HC SUTURE ETHILON 6-0 18"
|
Facility
IP
|
$24.76
|
|
| Hospital Charge Code |
901603485
|
|
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 6-0 18"
|
Facility
OP
|
$24.76
|
|
| Hospital Charge Code |
901603485
|
|
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 6-0 PC1 121000
|
Facility
IP
|
$29.77
|
|
| Hospital Charge Code |
901694944
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$26.79 |
| Rate for Payer: Cash Price |
$13.40
|
| Rate for Payer: Central Health Plan Commercial |
$23.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.91
|
| Rate for Payer: Galaxy Health WC |
$25.30
|
| Rate for Payer: Global Benefits Group Commercial |
$17.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.95
|
| Rate for Payer: Multiplan Commercial |
$22.33
|
| Rate for Payer: Networks By Design Commercial |
$19.35
|
| Rate for Payer: Prime Health Services Commercial |
$25.30
|
|
|
HC SUTURE ETHILON 6-0 PC1 121000
|
Facility
OP
|
$29.77
|
|
| Hospital Charge Code |
901694944
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.95 |
| Max. Negotiated Rate |
$26.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.08
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.37
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.59
|
| Rate for Payer: BCBS Transplant Transplant |
$17.86
|
| Rate for Payer: Blue Shield of California Commercial |
$18.73
|
| Rate for Payer: Blue Shield of California EPN |
$14.56
|
| Rate for Payer: Cash Price |
$13.40
|
| Rate for Payer: Central Health Plan Commercial |
$23.82
|
| Rate for Payer: Cigna of CA HMO |
$19.05
|
| Rate for Payer: Cigna of CA PPO |
$22.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.91
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.91
|
| Rate for Payer: Galaxy Health WC |
$25.30
|
| Rate for Payer: Global Benefits Group Commercial |
$17.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.79
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.33
|
| Rate for Payer: IEHP medi-cal |
$10.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.95
|
| Rate for Payer: Multiplan Commercial |
$22.33
|
| Rate for Payer: Networks By Design Commercial |
$19.35
|
| Rate for Payer: Prime Health Services Commercial |
$25.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.86
|
| Rate for Payer: Riverside University Health MISP |
$11.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.88
|
| Rate for Payer: United Healthcare All Other HMO |
$14.88
|
| Rate for Payer: United Healthcare HMO Rider |
$14.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.30
|
| Rate for Payer: Vantage Medical Group Senior |
$25.30
|
|
|
HC SUTURE ETHILON MONO PS-1 18"
|
Facility
OP
|
$29.52
|
|
| Hospital Charge Code |
901694633
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$26.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.93
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.09
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.44
|
| Rate for Payer: BCBS Transplant Transplant |
$17.71
|
| Rate for Payer: Blue Shield of California Commercial |
$18.57
|
| Rate for Payer: Blue Shield of California EPN |
$14.44
|
| Rate for Payer: Cash Price |
$13.28
|
| Rate for Payer: Central Health Plan Commercial |
$23.62
|
| Rate for Payer: Cigna of CA HMO |
$18.89
|
| Rate for Payer: Cigna of CA PPO |
$21.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.81
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.81
|
| Rate for Payer: Galaxy Health WC |
$25.09
|
| Rate for Payer: Global Benefits Group Commercial |
$17.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.57
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.14
|
| Rate for Payer: IEHP medi-cal |
$10.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.90
|
| Rate for Payer: Multiplan Commercial |
$22.14
|
| Rate for Payer: Networks By Design Commercial |
$19.19
|
| Rate for Payer: Prime Health Services Commercial |
$25.09
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.71
|
| Rate for Payer: Riverside University Health MISP |
$11.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.76
|
| Rate for Payer: United Healthcare All Other HMO |
$14.76
|
| Rate for Payer: United Healthcare HMO Rider |
$14.76
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.76
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.09
|
| Rate for Payer: Vantage Medical Group Senior |
$25.09
|
|
|
HC SUTURE ETHILON MONO PS-1 18"
|
Facility
IP
|
$29.52
|
|
| Hospital Charge Code |
901694633
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.90 |
| Max. Negotiated Rate |
$26.57 |
| Rate for Payer: Cash Price |
$13.28
|
| Rate for Payer: Central Health Plan Commercial |
$23.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.81
|
| Rate for Payer: Galaxy Health WC |
$25.09
|
| Rate for Payer: Global Benefits Group Commercial |
$17.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.90
|
| Rate for Payer: Multiplan Commercial |
$22.14
|
| Rate for Payer: Networks By Design Commercial |
$19.19
|
| Rate for Payer: Prime Health Services Commercial |
$25.09
|
|
|
HC SUTURE ETHILON SZ 2 100111
|
Facility
OP
|
$22.71
|
|
| Hospital Charge Code |
901693113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.54 |
| Max. Negotiated Rate |
$20.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.49
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13.42
|
| Rate for Payer: BCBS Transplant Transplant |
$13.63
|
| Rate for Payer: Blue Shield of California Commercial |
$14.28
|
| Rate for Payer: Blue Shield of California EPN |
$11.11
|
| Rate for Payer: Cash Price |
$10.22
|
| Rate for Payer: Central Health Plan Commercial |
$18.17
|
| Rate for Payer: Cigna of CA HMO |
$14.53
|
| Rate for Payer: Cigna of CA PPO |
$16.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.08
|
| Rate for Payer: Galaxy Health WC |
$19.30
|
| Rate for Payer: Global Benefits Group Commercial |
$13.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.44
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.03
|
| Rate for Payer: IEHP medi-cal |
$7.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$17.03
|
| Rate for Payer: Networks By Design Commercial |
$14.76
|
| Rate for Payer: Prime Health Services Commercial |
$19.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$13.63
|
| Rate for Payer: Riverside University Health MISP |
$9.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.36
|
| Rate for Payer: United Healthcare All Other HMO |
$11.36
|
| Rate for Payer: United Healthcare HMO Rider |
$11.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.30
|
| Rate for Payer: Vantage Medical Group Senior |
$19.30
|
|
|
HC SUTURE ETHILON SZ 2 100111
|
Facility
IP
|
$22.71
|
|
| Hospital Charge Code |
901693113
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.54 |
| Max. Negotiated Rate |
$20.44 |
| Rate for Payer: Cash Price |
$10.22
|
| Rate for Payer: Central Health Plan Commercial |
$18.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.08
|
| Rate for Payer: Galaxy Health WC |
$19.30
|
| Rate for Payer: Global Benefits Group Commercial |
$13.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.54
|
| Rate for Payer: Multiplan Commercial |
$17.03
|
| Rate for Payer: Networks By Design Commercial |
$14.76
|
| Rate for Payer: Prime Health Services Commercial |
$19.30
|
|
|
HC SUTURE EYELID, FULL THICKNESS
|
Facility
IP
|
$6,794.00
|
|
|
Service Code
|
CPT 67935
|
| Hospital Charge Code |
900501309
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,358.80 |
| Max. Negotiated Rate |
$6,114.60 |
| Rate for Payer: Cash Price |
$3,057.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,435.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,717.60
|
| Rate for Payer: Galaxy Health WC |
$5,774.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,076.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,114.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,531.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,358.80
|
| Rate for Payer: Multiplan Commercial |
$5,095.50
|
| Rate for Payer: Networks By Design Commercial |
$4,416.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,774.90
|
|
|
HC SUTURE EYELID, FULL THICKNESS
|
Facility
OP
|
$6,794.00
|
|
|
Service Code
|
CPT 67935
|
| Hospital Charge Code |
900501309
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,919.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: BCBS Transplant Transplant |
$4,076.40
|
| Rate for Payer: Caremore Medicare Advantage |
$2,919.67
|
| Rate for Payer: Cash Price |
$3,057.30
|
| Rate for Payer: Cash Price |
$3,057.30
|
| Rate for Payer: Cash Price |
$3,057.30
|
| Rate for Payer: Cash Price |
$3,057.30
|
| Rate for Payer: Central Health Plan Commercial |
$5,435.20
|
| Rate for Payer: Cigna of CA PPO |
$5,027.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,379.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,941.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,919.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,919.67
|
| Rate for Payer: Galaxy Health WC |
$5,774.90
|
| Rate for Payer: Global Benefits Group Commercial |
$4,076.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$6,114.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5,095.50
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,788.26
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,919.67
|
| Rate for Payer: Innovage PACE Commercial |
$4,379.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,531.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,919.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,358.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,912.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,912.36
|
| Rate for Payer: Multiplan Commercial |
$5,095.50
|
| Rate for Payer: Networks By Design Commercial |
$4,416.10
|
| Rate for Payer: Prime Health Services Commercial |
$5,774.90
|
| Rate for Payer: Prime Health Services Medicare |
$3,094.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$4,076.40
|
| Rate for Payer: Riverside University Health MISP |
$3,211.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,076.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,397.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,397.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,397.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,397.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,919.67
|
|
|
HC SUTURE EYELID,PARTIAL THICKNES
|
Facility
OP
|
$6,148.00
|
|
|
Service Code
|
CPT 67930
|
| Hospital Charge Code |
900501413
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$6,248.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,919.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$3,688.80
|
| Rate for Payer: Caremore Medicare Advantage |
$2,919.67
|
| Rate for Payer: Cash Price |
$2,766.60
|
| Rate for Payer: Cash Price |
$2,766.60
|
| Rate for Payer: Cash Price |
$2,766.60
|
| Rate for Payer: Cash Price |
$2,766.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,918.40
|
| Rate for Payer: Cigna of CA PPO |
$4,549.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4,379.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,941.55
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,919.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,919.67
|
| Rate for Payer: Galaxy Health WC |
$5,225.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,688.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,533.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4,611.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4,788.26
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,919.67
|
| Rate for Payer: Innovage PACE Commercial |
$4,379.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,100.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,919.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,229.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,912.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,912.36
|
| Rate for Payer: Multiplan Commercial |
$4,611.00
|
| Rate for Payer: Networks By Design Commercial |
$3,996.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,225.80
|
| Rate for Payer: Prime Health Services Medicare |
$3,094.85
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3,688.80
|
| Rate for Payer: Riverside University Health MISP |
$3,211.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3,688.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3,074.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3,074.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3,074.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3,074.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4,379.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3,211.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,919.67
|
|
|
HC SUTURE EYELID,PARTIAL THICKNES
|
Facility
IP
|
$6,148.00
|
|
|
Service Code
|
CPT 67930
|
| Hospital Charge Code |
900501413
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$1,229.60 |
| Max. Negotiated Rate |
$5,533.20 |
| Rate for Payer: Cash Price |
$2,766.60
|
| Rate for Payer: Central Health Plan Commercial |
$4,918.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,459.20
|
| Rate for Payer: Galaxy Health WC |
$5,225.80
|
| Rate for Payer: Global Benefits Group Commercial |
$3,688.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5,533.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4,100.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,229.60
|
| Rate for Payer: Multiplan Commercial |
$4,611.00
|
| Rate for Payer: Networks By Design Commercial |
$3,996.20
|
| Rate for Payer: Prime Health Services Commercial |
$5,225.80
|
|
|
HC SUTURE HAND/FOOT 1 DIGIT NERVE
|
Facility
OP
|
$12,995.00
|
|
|
Service Code
|
CPT 64831
|
| Hospital Charge Code |
900501398
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$11,695.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10,567.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,618.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,653.62
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,412.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7,084.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,797.00
|
| Rate for Payer: Caremore Medicare Advantage |
$2,412.38
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,396.00
|
| Rate for Payer: Cigna of CA PPO |
$9,616.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,618.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,256.71
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,412.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,412.38
|
| Rate for Payer: Galaxy Health WC |
$11,045.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,797.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,695.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,746.25
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,956.30
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: IEHP Medicare Advantage |
$2,412.38
|
| Rate for Payer: Innovage PACE Commercial |
$3,618.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,667.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,412.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,599.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,232.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,232.59
|
| Rate for Payer: Multiplan Commercial |
$9,746.25
|
| Rate for Payer: Networks By Design Commercial |
$8,446.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,045.75
|
| Rate for Payer: Prime Health Services Medicare |
$2,557.12
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,797.00
|
| Rate for Payer: Riverside University Health MISP |
$2,653.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,797.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,497.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,497.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,497.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,497.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,618.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,653.62
|
| Rate for Payer: Vantage Medical Group Senior |
$2,412.38
|
|
|
HC SUTURE HAND/FOOT 1 DIGIT NERVE
|
Facility
IP
|
$12,995.00
|
|
|
Service Code
|
CPT 64831
|
| Hospital Charge Code |
900501398
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,599.00 |
| Max. Negotiated Rate |
$11,695.50 |
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,396.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,198.00
|
| Rate for Payer: Galaxy Health WC |
$11,045.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,797.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,695.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,667.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,599.00
|
| Rate for Payer: Multiplan Commercial |
$9,746.25
|
| Rate for Payer: Networks By Design Commercial |
$8,446.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,045.75
|
|
|
HC SUTURE HAND/FOOT NERVE EA ADDL
|
Facility
OP
|
$12,995.00
|
|
|
Service Code
|
CPT 64832
|
| Hospital Charge Code |
900501552
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$400.00 |
| Max. Negotiated Rate |
$11,695.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$400.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11,045.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7,147.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7,147.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1,833.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2,356.00
|
| Rate for Payer: BCBS Transplant Transplant |
$7,797.00
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,396.00
|
| Rate for Payer: Cigna of CA PPO |
$9,616.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,045.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,198.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$5,198.00
|
| Rate for Payer: Galaxy Health WC |
$11,045.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,797.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,695.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9,746.25
|
| Rate for Payer: IEHP medi-cal |
$936.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,667.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,599.00
|
| Rate for Payer: Multiplan Commercial |
$9,746.25
|
| Rate for Payer: Networks By Design Commercial |
$8,446.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,045.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7,797.00
|
| Rate for Payer: Riverside University Health MISP |
$5,198.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7,797.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,497.50
|
| Rate for Payer: United Healthcare All Other HMO |
$6,497.50
|
| Rate for Payer: United Healthcare HMO Rider |
$6,497.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,497.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11,045.75
|
| Rate for Payer: Vantage Medical Group Senior |
$11,045.75
|
|
|
HC SUTURE HAND/FOOT NERVE EA ADDL
|
Facility
IP
|
$12,995.00
|
|
|
Service Code
|
CPT 64832
|
| Hospital Charge Code |
900501552
|
|
Hospital Revenue Code
|
450
|
| Min. Negotiated Rate |
$2,599.00 |
| Max. Negotiated Rate |
$11,695.50 |
| Rate for Payer: Cash Price |
$5,847.75
|
| Rate for Payer: Central Health Plan Commercial |
$10,396.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,198.00
|
| Rate for Payer: Galaxy Health WC |
$11,045.75
|
| Rate for Payer: Global Benefits Group Commercial |
$7,797.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$11,695.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8,667.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,599.00
|
| Rate for Payer: Multiplan Commercial |
$9,746.25
|
| Rate for Payer: Networks By Design Commercial |
$8,446.75
|
| Rate for Payer: Prime Health Services Commercial |
$11,045.75
|
|
|
HC SUTURE MONDO PDS II 48"109879
|
Facility
IP
|
$38.62
|
|
| Hospital Charge Code |
901693118
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
|
|
HC SUTURE MONDO PDS II 48"109879
|
Facility
OP
|
$38.62
|
|
| Hospital Charge Code |
901693118
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.72 |
| Max. Negotiated Rate |
$34.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.24
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.82
|
| Rate for Payer: BCBS Transplant Transplant |
$23.17
|
| Rate for Payer: Blue Shield of California Commercial |
$24.29
|
| Rate for Payer: Blue Shield of California EPN |
$18.89
|
| Rate for Payer: Cash Price |
$17.38
|
| Rate for Payer: Central Health Plan Commercial |
$30.90
|
| Rate for Payer: Cigna of CA HMO |
$24.72
|
| Rate for Payer: Cigna of CA PPO |
$28.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.45
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.45
|
| Rate for Payer: Galaxy Health WC |
$32.83
|
| Rate for Payer: Global Benefits Group Commercial |
$23.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.76
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28.96
|
| Rate for Payer: IEHP medi-cal |
$13.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.72
|
| Rate for Payer: Multiplan Commercial |
$28.96
|
| Rate for Payer: Networks By Design Commercial |
$25.10
|
| Rate for Payer: Prime Health Services Commercial |
$32.83
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: Riverside University Health MISP |
$15.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.31
|
| Rate for Payer: United Healthcare All Other HMO |
$19.31
|
| Rate for Payer: United Healthcare HMO Rider |
$19.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.83
|
| Rate for Payer: Vantage Medical Group Senior |
$32.83
|
|
