|
HC SUTURE MONOCCRYL 4-0 PS-2 18"
|
Facility
OP
|
$40.92
|
|
| Hospital Charge Code |
901694642
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.18 |
| Max. Negotiated Rate |
$36.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$34.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.18
|
| Rate for Payer: BCBS Transplant Transplant |
$24.55
|
| Rate for Payer: Blue Shield of California Commercial |
$25.74
|
| Rate for Payer: Blue Shield of California EPN |
$20.01
|
| Rate for Payer: Cash Price |
$18.41
|
| Rate for Payer: Central Health Plan Commercial |
$32.74
|
| Rate for Payer: Cigna of CA HMO |
$26.19
|
| Rate for Payer: Cigna of CA PPO |
$30.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.37
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.37
|
| Rate for Payer: Galaxy Health WC |
$34.78
|
| Rate for Payer: Global Benefits Group Commercial |
$24.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30.69
|
| Rate for Payer: IEHP medi-cal |
$14.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.18
|
| Rate for Payer: Multiplan Commercial |
$30.69
|
| Rate for Payer: Networks By Design Commercial |
$26.60
|
| Rate for Payer: Prime Health Services Commercial |
$34.78
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24.55
|
| Rate for Payer: Riverside University Health MISP |
$16.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.55
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.46
|
| Rate for Payer: United Healthcare All Other HMO |
$20.46
|
| Rate for Payer: United Healthcare HMO Rider |
$20.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.78
|
| Rate for Payer: Vantage Medical Group Senior |
$34.78
|
|
|
HC SUTURE MONOCCRYL 4-0 PS-2 18"
|
Facility
IP
|
$40.92
|
|
| Hospital Charge Code |
901694642
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.18 |
| Max. Negotiated Rate |
$36.83 |
| Rate for Payer: Cash Price |
$18.41
|
| Rate for Payer: Central Health Plan Commercial |
$32.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.37
|
| Rate for Payer: Galaxy Health WC |
$34.78
|
| Rate for Payer: Global Benefits Group Commercial |
$24.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.18
|
| Rate for Payer: Multiplan Commercial |
$30.69
|
| Rate for Payer: Networks By Design Commercial |
$26.60
|
| Rate for Payer: Prime Health Services Commercial |
$34.78
|
|
|
HC SUTURE MONOCRYL 3-0 18" PS-2
|
Facility
OP
|
$34.28
|
|
| Hospital Charge Code |
901694884
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.86 |
| Max. Negotiated Rate |
$30.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$29.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.85
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.25
|
| Rate for Payer: BCBS Transplant Transplant |
$20.57
|
| Rate for Payer: Blue Shield of California Commercial |
$21.56
|
| Rate for Payer: Blue Shield of California EPN |
$16.76
|
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: Central Health Plan Commercial |
$27.42
|
| Rate for Payer: Cigna of CA HMO |
$21.94
|
| Rate for Payer: Cigna of CA PPO |
$25.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.71
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.71
|
| Rate for Payer: Galaxy Health WC |
$29.14
|
| Rate for Payer: Global Benefits Group Commercial |
$20.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.85
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$25.71
|
| Rate for Payer: IEHP medi-cal |
$12.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$25.71
|
| Rate for Payer: Networks By Design Commercial |
$22.28
|
| Rate for Payer: Prime Health Services Commercial |
$29.14
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$20.57
|
| Rate for Payer: Riverside University Health MISP |
$13.71
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.57
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.14
|
| Rate for Payer: United Healthcare All Other HMO |
$17.14
|
| Rate for Payer: United Healthcare HMO Rider |
$17.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.14
|
| Rate for Payer: Vantage Medical Group Senior |
$29.14
|
|
|
HC SUTURE MONOCRYL 3-0 18" PS-2
|
Facility
IP
|
$34.28
|
|
| Hospital Charge Code |
901694884
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.86 |
| Max. Negotiated Rate |
$30.85 |
| Rate for Payer: Cash Price |
$15.43
|
| Rate for Payer: Central Health Plan Commercial |
$27.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.71
|
| Rate for Payer: Galaxy Health WC |
$29.14
|
| Rate for Payer: Global Benefits Group Commercial |
$20.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.85
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.86
|
| Rate for Payer: Multiplan Commercial |
$25.71
|
| Rate for Payer: Networks By Design Commercial |
$22.28
|
| Rate for Payer: Prime Health Services Commercial |
$29.14
|
|
|
HC SUTURE MONOCRYL 3-0 27" MCP936H
|
Facility
OP
|
$50.27
|
|
| Hospital Charge Code |
901691015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$45.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$42.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.70
|
| Rate for Payer: BCBS Transplant Transplant |
$30.16
|
| Rate for Payer: Blue Shield of California Commercial |
$31.62
|
| Rate for Payer: Blue Shield of California EPN |
$24.58
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Central Health Plan Commercial |
$40.22
|
| Rate for Payer: Cigna of CA HMO |
$32.17
|
| Rate for Payer: Cigna of CA PPO |
$37.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.11
|
| Rate for Payer: Galaxy Health WC |
$42.73
|
| Rate for Payer: Global Benefits Group Commercial |
$30.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.24
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.70
|
| Rate for Payer: IEHP medi-cal |
$17.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.05
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: Networks By Design Commercial |
$32.68
|
| Rate for Payer: Prime Health Services Commercial |
$42.73
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.16
|
| Rate for Payer: Riverside University Health MISP |
$20.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.14
|
| Rate for Payer: United Healthcare All Other HMO |
$25.14
|
| Rate for Payer: United Healthcare HMO Rider |
$25.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.73
|
| Rate for Payer: Vantage Medical Group Senior |
$42.73
|
|
|
HC SUTURE MONOCRYL 3-0 27" MCP936H
|
Facility
IP
|
$50.27
|
|
| Hospital Charge Code |
901691015
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$45.24 |
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Central Health Plan Commercial |
$40.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.11
|
| Rate for Payer: Galaxy Health WC |
$42.73
|
| Rate for Payer: Global Benefits Group Commercial |
$30.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.05
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: Networks By Design Commercial |
$32.68
|
| Rate for Payer: Prime Health Services Commercial |
$42.73
|
|
|
HC SUTURE MONOCRYL 4-0 227388
|
Facility
OP
|
$44.69
|
|
| Hospital Charge Code |
901691009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.94 |
| Max. Negotiated Rate |
$40.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$37.99
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$21.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.40
|
| Rate for Payer: BCBS Transplant Transplant |
$26.81
|
| Rate for Payer: Blue Shield of California Commercial |
$28.11
|
| Rate for Payer: Blue Shield of California EPN |
$21.85
|
| Rate for Payer: Cash Price |
$20.11
|
| Rate for Payer: Central Health Plan Commercial |
$35.75
|
| Rate for Payer: Cigna of CA HMO |
$28.60
|
| Rate for Payer: Cigna of CA PPO |
$33.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.88
|
| Rate for Payer: Galaxy Health WC |
$37.99
|
| Rate for Payer: Global Benefits Group Commercial |
$26.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.22
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$33.52
|
| Rate for Payer: IEHP medi-cal |
$15.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.94
|
| Rate for Payer: Multiplan Commercial |
$33.52
|
| Rate for Payer: Networks By Design Commercial |
$29.05
|
| Rate for Payer: Prime Health Services Commercial |
$37.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$26.81
|
| Rate for Payer: Riverside University Health MISP |
$17.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$26.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$26.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.34
|
| Rate for Payer: United Healthcare All Other HMO |
$22.34
|
| Rate for Payer: United Healthcare HMO Rider |
$22.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.34
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.99
|
| Rate for Payer: Vantage Medical Group Senior |
$37.99
|
|
|
HC SUTURE MONOCRYL 4-0 227388
|
Facility
IP
|
$44.69
|
|
| Hospital Charge Code |
901691009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.94 |
| Max. Negotiated Rate |
$40.22 |
| Rate for Payer: Cash Price |
$20.11
|
| Rate for Payer: Central Health Plan Commercial |
$35.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.88
|
| Rate for Payer: Galaxy Health WC |
$37.99
|
| Rate for Payer: Global Benefits Group Commercial |
$26.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$29.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.94
|
| Rate for Payer: Multiplan Commercial |
$33.52
|
| Rate for Payer: Networks By Design Commercial |
$29.05
|
| Rate for Payer: Prime Health Services Commercial |
$37.99
|
|
|
HC SUTURE MONOCRYL 4-0 PS-2
|
Facility
IP
|
$42.56
|
|
| Hospital Charge Code |
901694885
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$38.30 |
| Rate for Payer: Cash Price |
$19.15
|
| Rate for Payer: Central Health Plan Commercial |
$34.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.02
|
| Rate for Payer: Galaxy Health WC |
$36.18
|
| Rate for Payer: Global Benefits Group Commercial |
$25.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.51
|
| Rate for Payer: Multiplan Commercial |
$31.92
|
| Rate for Payer: Networks By Design Commercial |
$27.66
|
| Rate for Payer: Prime Health Services Commercial |
$36.18
|
|
|
HC SUTURE MONOCRYL 4-0 PS-2
|
Facility
OP
|
$42.56
|
|
| Hospital Charge Code |
901694885
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.51 |
| Max. Negotiated Rate |
$38.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$36.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$23.41
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$23.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.14
|
| Rate for Payer: BCBS Transplant Transplant |
$25.54
|
| Rate for Payer: Blue Shield of California Commercial |
$26.77
|
| Rate for Payer: Blue Shield of California EPN |
$20.81
|
| Rate for Payer: Cash Price |
$19.15
|
| Rate for Payer: Central Health Plan Commercial |
$34.05
|
| Rate for Payer: Cigna of CA HMO |
$27.24
|
| Rate for Payer: Cigna of CA PPO |
$31.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$17.02
|
| Rate for Payer: Galaxy Health WC |
$36.18
|
| Rate for Payer: Global Benefits Group Commercial |
$25.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$31.92
|
| Rate for Payer: IEHP medi-cal |
$14.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.51
|
| Rate for Payer: Multiplan Commercial |
$31.92
|
| Rate for Payer: Networks By Design Commercial |
$27.66
|
| Rate for Payer: Prime Health Services Commercial |
$36.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$25.54
|
| Rate for Payer: Riverside University Health MISP |
$17.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.54
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.28
|
| Rate for Payer: United Healthcare All Other HMO |
$21.28
|
| Rate for Payer: United Healthcare HMO Rider |
$21.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.18
|
| Rate for Payer: Vantage Medical Group Senior |
$36.18
|
|
|
HC SUTURE MONOCRYL 5-0 227404
|
Facility
IP
|
$50.27
|
|
| Hospital Charge Code |
901691008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$45.24 |
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Central Health Plan Commercial |
$40.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.11
|
| Rate for Payer: Galaxy Health WC |
$42.73
|
| Rate for Payer: Global Benefits Group Commercial |
$30.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.05
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: Networks By Design Commercial |
$32.68
|
| Rate for Payer: Prime Health Services Commercial |
$42.73
|
|
|
HC SUTURE MONOCRYL 5-0 227404
|
Facility
OP
|
$50.27
|
|
| Hospital Charge Code |
901691008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.05 |
| Max. Negotiated Rate |
$45.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30.53
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$42.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.65
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.70
|
| Rate for Payer: BCBS Transplant Transplant |
$30.16
|
| Rate for Payer: Blue Shield of California Commercial |
$31.62
|
| Rate for Payer: Blue Shield of California EPN |
$24.58
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Central Health Plan Commercial |
$40.22
|
| Rate for Payer: Cigna of CA HMO |
$32.17
|
| Rate for Payer: Cigna of CA PPO |
$37.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.11
|
| Rate for Payer: Galaxy Health WC |
$42.73
|
| Rate for Payer: Global Benefits Group Commercial |
$30.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.24
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.70
|
| Rate for Payer: IEHP medi-cal |
$17.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.05
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: Networks By Design Commercial |
$32.68
|
| Rate for Payer: Prime Health Services Commercial |
$42.73
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.16
|
| Rate for Payer: Riverside University Health MISP |
$20.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.14
|
| Rate for Payer: United Healthcare All Other HMO |
$25.14
|
| Rate for Payer: United Healthcare HMO Rider |
$25.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.73
|
| Rate for Payer: Vantage Medical Group Senior |
$42.73
|
|
|
HC SUTURE MONOCRYL 5-0 P-3
|
Facility
IP
|
$32.96
|
|
| Hospital Charge Code |
901694941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$29.66 |
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Central Health Plan Commercial |
$26.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.18
|
| Rate for Payer: Galaxy Health WC |
$28.02
|
| Rate for Payer: Global Benefits Group Commercial |
$19.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.59
|
| Rate for Payer: Multiplan Commercial |
$24.72
|
| Rate for Payer: Networks By Design Commercial |
$21.42
|
| Rate for Payer: Prime Health Services Commercial |
$28.02
|
|
|
HC SUTURE MONOCRYL 5-0 P-3
|
Facility
OP
|
$32.96
|
|
| Hospital Charge Code |
901694941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$29.66 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.47
|
| Rate for Payer: BCBS Transplant Transplant |
$19.78
|
| Rate for Payer: Blue Shield of California Commercial |
$20.73
|
| Rate for Payer: Blue Shield of California EPN |
$16.12
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Central Health Plan Commercial |
$26.37
|
| Rate for Payer: Cigna of CA HMO |
$21.09
|
| Rate for Payer: Cigna of CA PPO |
$24.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.18
|
| Rate for Payer: Galaxy Health WC |
$28.02
|
| Rate for Payer: Global Benefits Group Commercial |
$19.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.66
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24.72
|
| Rate for Payer: IEHP medi-cal |
$11.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.59
|
| Rate for Payer: Multiplan Commercial |
$24.72
|
| Rate for Payer: Networks By Design Commercial |
$21.42
|
| Rate for Payer: Prime Health Services Commercial |
$28.02
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19.78
|
| Rate for Payer: Riverside University Health MISP |
$13.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.48
|
| Rate for Payer: United Healthcare All Other HMO |
$16.48
|
| Rate for Payer: United Healthcare HMO Rider |
$16.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.02
|
| Rate for Payer: Vantage Medical Group Senior |
$28.02
|
|
|
HC SUTURE MONOCRYL 6-0
|
Facility
OP
|
$50.84
|
|
| Hospital Charge Code |
901691016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$45.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$43.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.96
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.04
|
| Rate for Payer: BCBS Transplant Transplant |
$30.50
|
| Rate for Payer: Blue Shield of California Commercial |
$31.98
|
| Rate for Payer: Blue Shield of California EPN |
$24.86
|
| Rate for Payer: Cash Price |
$22.88
|
| Rate for Payer: Central Health Plan Commercial |
$40.67
|
| Rate for Payer: Cigna of CA HMO |
$32.54
|
| Rate for Payer: Cigna of CA PPO |
$37.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.34
|
| Rate for Payer: Galaxy Health WC |
$43.21
|
| Rate for Payer: Global Benefits Group Commercial |
$30.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.76
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$38.13
|
| Rate for Payer: IEHP medi-cal |
$17.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.17
|
| Rate for Payer: Multiplan Commercial |
$38.13
|
| Rate for Payer: Networks By Design Commercial |
$33.05
|
| Rate for Payer: Prime Health Services Commercial |
$43.21
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.50
|
| Rate for Payer: Riverside University Health MISP |
$20.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.42
|
| Rate for Payer: United Healthcare All Other HMO |
$25.42
|
| Rate for Payer: United Healthcare HMO Rider |
$25.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.21
|
| Rate for Payer: Vantage Medical Group Senior |
$43.21
|
|
|
HC SUTURE MONOCRYL 6-0
|
Facility
IP
|
$50.84
|
|
| Hospital Charge Code |
901691016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.17 |
| Max. Negotiated Rate |
$45.76 |
| Rate for Payer: Cash Price |
$22.88
|
| Rate for Payer: Central Health Plan Commercial |
$40.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.34
|
| Rate for Payer: Galaxy Health WC |
$43.21
|
| Rate for Payer: Global Benefits Group Commercial |
$30.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.17
|
| Rate for Payer: Multiplan Commercial |
$38.13
|
| Rate for Payer: Networks By Design Commercial |
$33.05
|
| Rate for Payer: Prime Health Services Commercial |
$43.21
|
|
|
HC SUTURE MRSILN 5MM BP1 107254
|
Facility
OP
|
$218.75
|
|
| Hospital Charge Code |
901694649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.75 |
| Max. Negotiated Rate |
$196.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$132.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$185.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$120.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$120.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$129.24
|
| Rate for Payer: BCBS Transplant Transplant |
$131.25
|
| Rate for Payer: Blue Shield of California Commercial |
$137.59
|
| Rate for Payer: Blue Shield of California EPN |
$106.97
|
| Rate for Payer: Cash Price |
$98.44
|
| Rate for Payer: Central Health Plan Commercial |
$175.00
|
| Rate for Payer: Cigna of CA HMO |
$140.00
|
| Rate for Payer: Cigna of CA PPO |
$161.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$87.50
|
| Rate for Payer: Galaxy Health WC |
$185.94
|
| Rate for Payer: Global Benefits Group Commercial |
$131.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.88
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$164.06
|
| Rate for Payer: IEHP medi-cal |
$76.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.75
|
| Rate for Payer: Multiplan Commercial |
$164.06
|
| Rate for Payer: Networks By Design Commercial |
$142.19
|
| Rate for Payer: Prime Health Services Commercial |
$185.94
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$131.25
|
| Rate for Payer: Riverside University Health MISP |
$87.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$131.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$131.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$109.38
|
| Rate for Payer: United Healthcare All Other HMO |
$109.38
|
| Rate for Payer: United Healthcare HMO Rider |
$109.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$109.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$185.94
|
| Rate for Payer: Vantage Medical Group Senior |
$185.94
|
|
|
HC SUTURE MRSILN 5MM BP1 107254
|
Facility
IP
|
$218.75
|
|
| Hospital Charge Code |
901694649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.75 |
| Max. Negotiated Rate |
$196.88 |
| Rate for Payer: Cash Price |
$98.44
|
| Rate for Payer: Central Health Plan Commercial |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.50
|
| Rate for Payer: Galaxy Health WC |
$185.94
|
| Rate for Payer: Global Benefits Group Commercial |
$131.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.75
|
| Rate for Payer: Multiplan Commercial |
$164.06
|
| Rate for Payer: Networks By Design Commercial |
$142.19
|
| Rate for Payer: Prime Health Services Commercial |
$185.94
|
|
|
HC SUTURE MRSILN CTX RS22 2152
|
Facility
OP
|
$177.38
|
|
| Hospital Charge Code |
901693123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.48 |
| Max. Negotiated Rate |
$159.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$107.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$150.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$97.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$97.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$85.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$104.80
|
| Rate for Payer: BCBS Transplant Transplant |
$106.43
|
| Rate for Payer: Blue Shield of California Commercial |
$111.57
|
| Rate for Payer: Blue Shield of California EPN |
$86.74
|
| Rate for Payer: Cash Price |
$79.82
|
| Rate for Payer: Central Health Plan Commercial |
$141.90
|
| Rate for Payer: Cigna of CA HMO |
$113.52
|
| Rate for Payer: Cigna of CA PPO |
$131.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$150.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$70.95
|
| Rate for Payer: Galaxy Health WC |
$150.77
|
| Rate for Payer: Global Benefits Group Commercial |
$106.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$159.64
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$133.04
|
| Rate for Payer: IEHP medi-cal |
$62.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$118.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.48
|
| Rate for Payer: Multiplan Commercial |
$133.04
|
| Rate for Payer: Networks By Design Commercial |
$115.30
|
| Rate for Payer: Prime Health Services Commercial |
$150.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$106.43
|
| Rate for Payer: Riverside University Health MISP |
$70.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$106.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$106.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$88.69
|
| Rate for Payer: United Healthcare All Other HMO |
$88.69
|
| Rate for Payer: United Healthcare HMO Rider |
$88.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$88.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$150.77
|
| Rate for Payer: Vantage Medical Group Senior |
$150.77
|
|
|
HC SUTURE MRSILN CTX RS22 2152
|
Facility
IP
|
$177.38
|
|
| Hospital Charge Code |
901693123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.48 |
| Max. Negotiated Rate |
$159.64 |
| Rate for Payer: Cash Price |
$79.82
|
| Rate for Payer: Central Health Plan Commercial |
$141.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.95
|
| Rate for Payer: Galaxy Health WC |
$150.77
|
| Rate for Payer: Global Benefits Group Commercial |
$106.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$159.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$118.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.48
|
| Rate for Payer: Multiplan Commercial |
$133.04
|
| Rate for Payer: Networks By Design Commercial |
$115.30
|
| Rate for Payer: Prime Health Services Commercial |
$150.77
|
|
|
HC SUTURE PDS 0 CI-1 102829
|
Facility
OP
|
$18.04
|
|
| Hospital Charge Code |
901694651
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$16.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15.33
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.66
|
| Rate for Payer: BCBS Transplant Transplant |
$10.82
|
| Rate for Payer: Blue Shield of California Commercial |
$11.35
|
| Rate for Payer: Blue Shield of California EPN |
$8.82
|
| Rate for Payer: Cash Price |
$8.12
|
| Rate for Payer: Central Health Plan Commercial |
$14.43
|
| Rate for Payer: Cigna of CA HMO |
$11.55
|
| Rate for Payer: Cigna of CA PPO |
$13.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.22
|
| Rate for Payer: Galaxy Health WC |
$15.33
|
| Rate for Payer: Global Benefits Group Commercial |
$10.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.24
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.53
|
| Rate for Payer: IEHP medi-cal |
$6.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.61
|
| Rate for Payer: Multiplan Commercial |
$13.53
|
| Rate for Payer: Networks By Design Commercial |
$11.73
|
| Rate for Payer: Prime Health Services Commercial |
$15.33
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.82
|
| Rate for Payer: Riverside University Health MISP |
$7.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.02
|
| Rate for Payer: United Healthcare All Other HMO |
$9.02
|
| Rate for Payer: United Healthcare HMO Rider |
$9.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.33
|
| Rate for Payer: Vantage Medical Group Senior |
$15.33
|
|
|
HC SUTURE PDS 0 CI-1 102829
|
Facility
IP
|
$18.04
|
|
| Hospital Charge Code |
901694651
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.61 |
| Max. Negotiated Rate |
$16.24 |
| Rate for Payer: Cash Price |
$8.12
|
| Rate for Payer: Central Health Plan Commercial |
$14.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.22
|
| Rate for Payer: Galaxy Health WC |
$15.33
|
| Rate for Payer: Global Benefits Group Commercial |
$10.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.61
|
| Rate for Payer: Multiplan Commercial |
$13.53
|
| Rate for Payer: Networks By Design Commercial |
$11.73
|
| Rate for Payer: Prime Health Services Commercial |
$15.33
|
|
|
HC SUTURE PDS 2-0 CT-1 128263
|
Facility
OP
|
$17.38
|
|
| Hospital Charge Code |
901693111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$15.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.55
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.27
|
| Rate for Payer: BCBS Transplant Transplant |
$10.43
|
| Rate for Payer: Blue Shield of California Commercial |
$10.93
|
| Rate for Payer: Blue Shield of California EPN |
$8.50
|
| Rate for Payer: Cash Price |
$7.82
|
| Rate for Payer: Central Health Plan Commercial |
$13.90
|
| Rate for Payer: Cigna of CA HMO |
$11.12
|
| Rate for Payer: Cigna of CA PPO |
$12.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.95
|
| Rate for Payer: Galaxy Health WC |
$14.77
|
| Rate for Payer: Global Benefits Group Commercial |
$10.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.64
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.04
|
| Rate for Payer: IEHP medi-cal |
$6.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.48
|
| Rate for Payer: Multiplan Commercial |
$13.04
|
| Rate for Payer: Networks By Design Commercial |
$11.30
|
| Rate for Payer: Prime Health Services Commercial |
$14.77
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.43
|
| Rate for Payer: Riverside University Health MISP |
$6.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.69
|
| Rate for Payer: United Healthcare All Other HMO |
$8.69
|
| Rate for Payer: United Healthcare HMO Rider |
$8.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.77
|
| Rate for Payer: Vantage Medical Group Senior |
$14.77
|
|
|
HC SUTURE PDS 2-0 CT-1 128263
|
Facility
IP
|
$17.38
|
|
| Hospital Charge Code |
901693111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.48 |
| Max. Negotiated Rate |
$15.64 |
| Rate for Payer: Cash Price |
$7.82
|
| Rate for Payer: Central Health Plan Commercial |
$13.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.95
|
| Rate for Payer: Galaxy Health WC |
$14.77
|
| Rate for Payer: Global Benefits Group Commercial |
$10.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.48
|
| Rate for Payer: Multiplan Commercial |
$13.04
|
| Rate for Payer: Networks By Design Commercial |
$11.30
|
| Rate for Payer: Prime Health Services Commercial |
$14.77
|
|
|
HC SUTURE PDS II 5-0 18" P-3
|
Facility
IP
|
$33.46
|
|
| Hospital Charge Code |
901601970
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.69 |
| Max. Negotiated Rate |
$30.11 |
| Rate for Payer: Cash Price |
$15.06
|
| Rate for Payer: Central Health Plan Commercial |
$26.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.38
|
| Rate for Payer: Galaxy Health WC |
$28.44
|
| Rate for Payer: Global Benefits Group Commercial |
$20.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.69
|
| Rate for Payer: Multiplan Commercial |
$25.10
|
| Rate for Payer: Networks By Design Commercial |
$21.75
|
| Rate for Payer: Prime Health Services Commercial |
$28.44
|
|
