|
HC SUTURE PROLENE 0 101004
|
Facility
OP
|
$16.81
|
|
| Hospital Charge Code |
901693104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$15.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.21
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.29
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.93
|
| Rate for Payer: BCBS Transplant Transplant |
$10.09
|
| Rate for Payer: Blue Shield of California Commercial |
$10.57
|
| Rate for Payer: Blue Shield of California EPN |
$8.22
|
| Rate for Payer: Cash Price |
$7.56
|
| Rate for Payer: Central Health Plan Commercial |
$13.45
|
| Rate for Payer: Cigna of CA HMO |
$10.76
|
| Rate for Payer: Cigna of CA PPO |
$12.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.72
|
| Rate for Payer: Galaxy Health WC |
$14.29
|
| Rate for Payer: Global Benefits Group Commercial |
$10.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.13
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.61
|
| Rate for Payer: IEHP medi-cal |
$5.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: Multiplan Commercial |
$12.61
|
| Rate for Payer: Networks By Design Commercial |
$10.93
|
| Rate for Payer: Prime Health Services Commercial |
$14.29
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.09
|
| Rate for Payer: Riverside University Health MISP |
$6.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.40
|
| Rate for Payer: United Healthcare All Other HMO |
$8.40
|
| Rate for Payer: United Healthcare HMO Rider |
$8.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.29
|
| Rate for Payer: Vantage Medical Group Senior |
$14.29
|
|
|
HC SUTURE PROLENE 0 101004
|
Facility
IP
|
$16.81
|
|
| Hospital Charge Code |
901693104
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$15.13 |
| Rate for Payer: Cash Price |
$7.56
|
| Rate for Payer: Central Health Plan Commercial |
$13.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.72
|
| Rate for Payer: Galaxy Health WC |
$14.29
|
| Rate for Payer: Global Benefits Group Commercial |
$10.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: Multiplan Commercial |
$12.61
|
| Rate for Payer: Networks By Design Commercial |
$10.93
|
| Rate for Payer: Prime Health Services Commercial |
$14.29
|
|
|
HC SUTURE PROLENE 0 CT-1 100077
|
Facility
IP
|
$17.22
|
|
| Hospital Charge Code |
901693105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.44 |
| Max. Negotiated Rate |
$15.50 |
| Rate for Payer: Cash Price |
$7.75
|
| Rate for Payer: Central Health Plan Commercial |
$13.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.89
|
| Rate for Payer: Galaxy Health WC |
$14.64
|
| Rate for Payer: Global Benefits Group Commercial |
$10.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.44
|
| Rate for Payer: Multiplan Commercial |
$12.92
|
| Rate for Payer: Networks By Design Commercial |
$11.19
|
| Rate for Payer: Prime Health Services Commercial |
$14.64
|
|
|
HC SUTURE PROLENE 0 CT-1 100077
|
Facility
OP
|
$17.22
|
|
| Hospital Charge Code |
901693105
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.44 |
| Max. Negotiated Rate |
$15.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.47
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.17
|
| Rate for Payer: BCBS Transplant Transplant |
$10.33
|
| Rate for Payer: Blue Shield of California Commercial |
$10.83
|
| Rate for Payer: Blue Shield of California EPN |
$8.42
|
| Rate for Payer: Cash Price |
$7.75
|
| Rate for Payer: Central Health Plan Commercial |
$13.78
|
| Rate for Payer: Cigna of CA HMO |
$11.02
|
| Rate for Payer: Cigna of CA PPO |
$12.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.89
|
| Rate for Payer: Galaxy Health WC |
$14.64
|
| Rate for Payer: Global Benefits Group Commercial |
$10.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.92
|
| Rate for Payer: IEHP medi-cal |
$6.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.44
|
| Rate for Payer: Multiplan Commercial |
$12.92
|
| Rate for Payer: Networks By Design Commercial |
$11.19
|
| Rate for Payer: Prime Health Services Commercial |
$14.64
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.33
|
| Rate for Payer: Riverside University Health MISP |
$6.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.61
|
| Rate for Payer: United Healthcare All Other HMO |
$8.61
|
| Rate for Payer: United Healthcare HMO Rider |
$8.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.64
|
| Rate for Payer: Vantage Medical Group Senior |
$14.64
|
|
|
HC SUTURE PROLENE 2-0 105153
|
Facility
OP
|
$41.25
|
|
| Hospital Charge Code |
901691007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25.05
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$35.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.37
|
| Rate for Payer: BCBS Transplant Transplant |
$24.75
|
| Rate for Payer: Blue Shield of California Commercial |
$25.95
|
| Rate for Payer: Blue Shield of California EPN |
$20.17
|
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Central Health Plan Commercial |
$33.00
|
| Rate for Payer: Cigna of CA HMO |
$26.40
|
| Rate for Payer: Cigna of CA PPO |
$30.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$35.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.50
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.50
|
| Rate for Payer: Galaxy Health WC |
$35.06
|
| Rate for Payer: Global Benefits Group Commercial |
$24.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.12
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30.94
|
| Rate for Payer: IEHP medi-cal |
$14.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.25
|
| Rate for Payer: Multiplan Commercial |
$30.94
|
| Rate for Payer: Networks By Design Commercial |
$26.81
|
| Rate for Payer: Prime Health Services Commercial |
$35.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24.75
|
| Rate for Payer: Riverside University Health MISP |
$16.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.62
|
| Rate for Payer: United Healthcare All Other HMO |
$20.62
|
| Rate for Payer: United Healthcare HMO Rider |
$20.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$35.06
|
| Rate for Payer: Vantage Medical Group Senior |
$35.06
|
|
|
HC SUTURE PROLENE 2-0 105153
|
Facility
IP
|
$41.25
|
|
| Hospital Charge Code |
901691007
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.25 |
| Max. Negotiated Rate |
$37.12 |
| Rate for Payer: Cash Price |
$18.56
|
| Rate for Payer: Central Health Plan Commercial |
$33.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.50
|
| Rate for Payer: Galaxy Health WC |
$35.06
|
| Rate for Payer: Global Benefits Group Commercial |
$24.75
|
| Rate for Payer: Health Management Network EPO/PPO |
$37.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.25
|
| Rate for Payer: Multiplan Commercial |
$30.94
|
| Rate for Payer: Networks By Design Commercial |
$26.81
|
| Rate for Payer: Prime Health Services Commercial |
$35.06
|
|
|
HC SUTURE PROLENE 2-0 30" 177478
|
Facility
IP
|
$73.47
|
|
| Hospital Charge Code |
901694869
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$66.12 |
| Rate for Payer: Cash Price |
$33.06
|
| Rate for Payer: Central Health Plan Commercial |
$58.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.39
|
| Rate for Payer: Galaxy Health WC |
$62.45
|
| Rate for Payer: Global Benefits Group Commercial |
$44.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$66.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.69
|
| Rate for Payer: Multiplan Commercial |
$55.10
|
| Rate for Payer: Networks By Design Commercial |
$47.76
|
| Rate for Payer: Prime Health Services Commercial |
$62.45
|
|
|
HC SUTURE PROLENE 2-0 30" 177478
|
Facility
OP
|
$73.47
|
|
| Hospital Charge Code |
901694869
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$14.69 |
| Max. Negotiated Rate |
$66.12 |
| Rate for Payer: Aetna of CA HMO/PPO |
$44.62
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$62.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$40.41
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$40.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$35.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43.41
|
| Rate for Payer: BCBS Transplant Transplant |
$44.08
|
| Rate for Payer: Blue Shield of California Commercial |
$46.21
|
| Rate for Payer: Blue Shield of California EPN |
$35.93
|
| Rate for Payer: Cash Price |
$33.06
|
| Rate for Payer: Central Health Plan Commercial |
$58.78
|
| Rate for Payer: Cigna of CA HMO |
$47.02
|
| Rate for Payer: Cigna of CA PPO |
$54.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$62.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$29.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$29.39
|
| Rate for Payer: Galaxy Health WC |
$62.45
|
| Rate for Payer: Global Benefits Group Commercial |
$44.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$66.12
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$55.10
|
| Rate for Payer: IEHP medi-cal |
$25.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$49.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.69
|
| Rate for Payer: Multiplan Commercial |
$55.10
|
| Rate for Payer: Networks By Design Commercial |
$47.76
|
| Rate for Payer: Prime Health Services Commercial |
$62.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$44.08
|
| Rate for Payer: Riverside University Health MISP |
$29.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$44.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$44.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$36.74
|
| Rate for Payer: United Healthcare All Other HMO |
$36.74
|
| Rate for Payer: United Healthcare HMO Rider |
$36.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$36.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$62.45
|
| Rate for Payer: Vantage Medical Group Senior |
$62.45
|
|
|
HC SUTURE PROLENE 3-0 36" V-5
|
Facility
OP
|
$51.99
|
|
| Hospital Charge Code |
901604310
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$46.79 |
| Rate for Payer: Aetna of CA HMO/PPO |
$31.57
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$44.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$28.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$28.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.72
|
| Rate for Payer: BCBS Transplant Transplant |
$31.19
|
| Rate for Payer: Blue Shield of California Commercial |
$32.70
|
| Rate for Payer: Blue Shield of California EPN |
$25.42
|
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Central Health Plan Commercial |
$41.59
|
| Rate for Payer: Cigna of CA HMO |
$33.27
|
| Rate for Payer: Cigna of CA PPO |
$38.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.80
|
| Rate for Payer: Galaxy Health WC |
$44.19
|
| Rate for Payer: Global Benefits Group Commercial |
$31.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.79
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$38.99
|
| Rate for Payer: IEHP medi-cal |
$18.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Multiplan Commercial |
$38.99
|
| Rate for Payer: Networks By Design Commercial |
$33.79
|
| Rate for Payer: Prime Health Services Commercial |
$44.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$31.19
|
| Rate for Payer: Riverside University Health MISP |
$20.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.00
|
| Rate for Payer: United Healthcare All Other HMO |
$26.00
|
| Rate for Payer: United Healthcare HMO Rider |
$26.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.19
|
| Rate for Payer: Vantage Medical Group Senior |
$44.19
|
|
|
HC SUTURE PROLENE 3-0 36" V-5
|
Facility
IP
|
$51.99
|
|
| Hospital Charge Code |
901604310
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.40 |
| Max. Negotiated Rate |
$46.79 |
| Rate for Payer: Cash Price |
$23.40
|
| Rate for Payer: Central Health Plan Commercial |
$41.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.80
|
| Rate for Payer: Galaxy Health WC |
$44.19
|
| Rate for Payer: Global Benefits Group Commercial |
$31.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$46.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.40
|
| Rate for Payer: Multiplan Commercial |
$38.99
|
| Rate for Payer: Networks By Design Commercial |
$33.79
|
| Rate for Payer: Prime Health Services Commercial |
$44.19
|
|
|
HC SUTURE PROLENE 4-0 18" FS-2
|
Facility
OP
|
$19.35
|
|
| Hospital Charge Code |
901604413
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$17.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.45
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.64
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.43
|
| Rate for Payer: BCBS Transplant Transplant |
$11.61
|
| Rate for Payer: Blue Shield of California Commercial |
$12.17
|
| Rate for Payer: Blue Shield of California EPN |
$9.46
|
| Rate for Payer: Cash Price |
$8.71
|
| Rate for Payer: Central Health Plan Commercial |
$15.48
|
| Rate for Payer: Cigna of CA HMO |
$12.38
|
| Rate for Payer: Cigna of CA PPO |
$14.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.74
|
| Rate for Payer: Galaxy Health WC |
$16.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.42
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.51
|
| Rate for Payer: IEHP medi-cal |
$6.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.87
|
| Rate for Payer: Multiplan Commercial |
$14.51
|
| Rate for Payer: Networks By Design Commercial |
$12.58
|
| Rate for Payer: Prime Health Services Commercial |
$16.45
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.61
|
| Rate for Payer: Riverside University Health MISP |
$7.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.68
|
| Rate for Payer: United Healthcare All Other HMO |
$9.68
|
| Rate for Payer: United Healthcare HMO Rider |
$9.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.45
|
| Rate for Payer: Vantage Medical Group Senior |
$16.45
|
|
|
HC SUTURE PROLENE 4-0 18" FS-2
|
Facility
IP
|
$19.35
|
|
| Hospital Charge Code |
901604413
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.87 |
| Max. Negotiated Rate |
$17.42 |
| Rate for Payer: Cash Price |
$8.71
|
| Rate for Payer: Central Health Plan Commercial |
$15.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.74
|
| Rate for Payer: Galaxy Health WC |
$16.45
|
| Rate for Payer: Global Benefits Group Commercial |
$11.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.87
|
| Rate for Payer: Multiplan Commercial |
$14.51
|
| Rate for Payer: Networks By Design Commercial |
$12.58
|
| Rate for Payer: Prime Health Services Commercial |
$16.45
|
|
|
HC SUTURE PROLENE 4-0 18" PS-2
|
Facility
IP
|
$38.79
|
|
| Hospital Charge Code |
901601305
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$34.91 |
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Central Health Plan Commercial |
$31.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.52
|
| Rate for Payer: Galaxy Health WC |
$32.97
|
| Rate for Payer: Global Benefits Group Commercial |
$23.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.76
|
| Rate for Payer: Multiplan Commercial |
$29.09
|
| Rate for Payer: Networks By Design Commercial |
$25.21
|
| Rate for Payer: Prime Health Services Commercial |
$32.97
|
|
|
HC SUTURE PROLENE 4-0 18" PS-2
|
Facility
OP
|
$38.79
|
|
| Hospital Charge Code |
901601305
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.76 |
| Max. Negotiated Rate |
$34.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.97
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.33
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.33
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.92
|
| Rate for Payer: BCBS Transplant Transplant |
$23.27
|
| Rate for Payer: Blue Shield of California Commercial |
$24.40
|
| Rate for Payer: Blue Shield of California EPN |
$18.97
|
| Rate for Payer: Cash Price |
$17.46
|
| Rate for Payer: Central Health Plan Commercial |
$31.03
|
| Rate for Payer: Cigna of CA HMO |
$24.83
|
| Rate for Payer: Cigna of CA PPO |
$28.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.52
|
| Rate for Payer: Galaxy Health WC |
$32.97
|
| Rate for Payer: Global Benefits Group Commercial |
$23.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.91
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.09
|
| Rate for Payer: IEHP medi-cal |
$13.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.76
|
| Rate for Payer: Multiplan Commercial |
$29.09
|
| Rate for Payer: Networks By Design Commercial |
$25.21
|
| Rate for Payer: Prime Health Services Commercial |
$32.97
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.27
|
| Rate for Payer: Riverside University Health MISP |
$15.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.40
|
| Rate for Payer: United Healthcare All Other HMO |
$19.40
|
| Rate for Payer: United Healthcare HMO Rider |
$19.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.97
|
| Rate for Payer: Vantage Medical Group Senior |
$32.97
|
|
|
HC SUTURE PROLENE 4-0 P-3 8699G
|
Facility
IP
|
$39.11
|
|
| Hospital Charge Code |
901692003
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.82 |
| Max. Negotiated Rate |
$35.20 |
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Central Health Plan Commercial |
$31.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.64
|
| Rate for Payer: Galaxy Health WC |
$33.24
|
| Rate for Payer: Global Benefits Group Commercial |
$23.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.82
|
| Rate for Payer: Multiplan Commercial |
$29.33
|
| Rate for Payer: Networks By Design Commercial |
$25.42
|
| Rate for Payer: Prime Health Services Commercial |
$33.24
|
|
|
HC SUTURE PROLENE 4-0 P-3 8699G
|
Facility
OP
|
$39.11
|
|
| Hospital Charge Code |
901692003
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.82 |
| Max. Negotiated Rate |
$35.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$33.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23.11
|
| Rate for Payer: BCBS Transplant Transplant |
$23.47
|
| Rate for Payer: Blue Shield of California Commercial |
$24.60
|
| Rate for Payer: Blue Shield of California EPN |
$19.12
|
| Rate for Payer: Cash Price |
$17.60
|
| Rate for Payer: Central Health Plan Commercial |
$31.29
|
| Rate for Payer: Cigna of CA HMO |
$25.03
|
| Rate for Payer: Cigna of CA PPO |
$28.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.64
|
| Rate for Payer: Galaxy Health WC |
$33.24
|
| Rate for Payer: Global Benefits Group Commercial |
$23.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$29.33
|
| Rate for Payer: IEHP medi-cal |
$13.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$26.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.82
|
| Rate for Payer: Multiplan Commercial |
$29.33
|
| Rate for Payer: Networks By Design Commercial |
$25.42
|
| Rate for Payer: Prime Health Services Commercial |
$33.24
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.47
|
| Rate for Payer: Riverside University Health MISP |
$15.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.56
|
| Rate for Payer: United Healthcare All Other HMO |
$19.56
|
| Rate for Payer: United Healthcare HMO Rider |
$19.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.24
|
| Rate for Payer: Vantage Medical Group Senior |
$33.24
|
|
|
HC SUTURE PROLENE 5-0 18" P-3
|
Facility
IP
|
$98.34
|
|
| Hospital Charge Code |
901601306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.67 |
| Max. Negotiated Rate |
$88.51 |
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: Central Health Plan Commercial |
$78.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.34
|
| Rate for Payer: Galaxy Health WC |
$83.59
|
| Rate for Payer: Global Benefits Group Commercial |
$59.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.67
|
| Rate for Payer: Multiplan Commercial |
$73.76
|
| Rate for Payer: Networks By Design Commercial |
$63.92
|
| Rate for Payer: Prime Health Services Commercial |
$83.59
|
|
|
HC SUTURE PROLENE 5-0 18" P-3
|
Facility
OP
|
$98.34
|
|
| Hospital Charge Code |
901601306
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.67 |
| Max. Negotiated Rate |
$88.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$83.59
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$54.09
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$54.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$47.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$58.10
|
| Rate for Payer: BCBS Transplant Transplant |
$59.00
|
| Rate for Payer: Blue Shield of California Commercial |
$61.86
|
| Rate for Payer: Blue Shield of California EPN |
$48.09
|
| Rate for Payer: Cash Price |
$44.25
|
| Rate for Payer: Central Health Plan Commercial |
$78.67
|
| Rate for Payer: Cigna of CA HMO |
$62.94
|
| Rate for Payer: Cigna of CA PPO |
$72.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$83.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$39.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$39.34
|
| Rate for Payer: Galaxy Health WC |
$83.59
|
| Rate for Payer: Global Benefits Group Commercial |
$59.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$88.51
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$73.76
|
| Rate for Payer: IEHP medi-cal |
$34.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$65.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.67
|
| Rate for Payer: Multiplan Commercial |
$73.76
|
| Rate for Payer: Networks By Design Commercial |
$63.92
|
| Rate for Payer: Prime Health Services Commercial |
$83.59
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$59.00
|
| Rate for Payer: Riverside University Health MISP |
$39.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$59.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$59.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.17
|
| Rate for Payer: United Healthcare All Other HMO |
$49.17
|
| Rate for Payer: United Healthcare HMO Rider |
$49.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$49.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$83.59
|
| Rate for Payer: Vantage Medical Group Senior |
$83.59
|
|
|
HC SUTURE PROLENE 5-0 30" RB-2
|
Facility
IP
|
$34.11
|
|
| Hospital Charge Code |
901604303
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$30.70 |
| Rate for Payer: Cash Price |
$15.35
|
| Rate for Payer: Central Health Plan Commercial |
$27.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.64
|
| Rate for Payer: Galaxy Health WC |
$28.99
|
| Rate for Payer: Global Benefits Group Commercial |
$20.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.82
|
| Rate for Payer: Multiplan Commercial |
$25.58
|
| Rate for Payer: Networks By Design Commercial |
$22.17
|
| Rate for Payer: Prime Health Services Commercial |
$28.99
|
|
|
HC SUTURE PROLENE 5-0 30" RB-2
|
Facility
OP
|
$34.11
|
|
| Hospital Charge Code |
901604303
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.82 |
| Max. Negotiated Rate |
$30.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.99
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.76
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.15
|
| Rate for Payer: BCBS Transplant Transplant |
$20.47
|
| Rate for Payer: Blue Shield of California Commercial |
$21.46
|
| Rate for Payer: Blue Shield of California EPN |
$16.68
|
| Rate for Payer: Cash Price |
$15.35
|
| Rate for Payer: Central Health Plan Commercial |
$27.29
|
| Rate for Payer: Cigna of CA HMO |
$21.83
|
| Rate for Payer: Cigna of CA PPO |
$25.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.64
|
| Rate for Payer: Galaxy Health WC |
$28.99
|
| Rate for Payer: Global Benefits Group Commercial |
$20.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$25.58
|
| Rate for Payer: IEHP medi-cal |
$11.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.82
|
| Rate for Payer: Multiplan Commercial |
$25.58
|
| Rate for Payer: Networks By Design Commercial |
$22.17
|
| Rate for Payer: Prime Health Services Commercial |
$28.99
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$20.47
|
| Rate for Payer: Riverside University Health MISP |
$13.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.06
|
| Rate for Payer: United Healthcare All Other HMO |
$17.06
|
| Rate for Payer: United Healthcare HMO Rider |
$17.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.99
|
| Rate for Payer: Vantage Medical Group Senior |
$28.99
|
|
|
HC SUTURE PROLENE 5-0 C-1 24" 8725H
|
Facility
IP
|
$95.00
|
|
| Hospital Charge Code |
901691017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Central Health Plan Commercial |
$76.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.00
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
|
|
HC SUTURE PROLENE 5-0 C-1 24" 8725H
|
Facility
OP
|
$95.00
|
|
| Hospital Charge Code |
901691017
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$19.00 |
| Max. Negotiated Rate |
$85.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.69
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$80.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$52.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$52.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.13
|
| Rate for Payer: BCBS Transplant Transplant |
$57.00
|
| Rate for Payer: Blue Shield of California Commercial |
$59.76
|
| Rate for Payer: Blue Shield of California EPN |
$46.46
|
| Rate for Payer: Cash Price |
$42.75
|
| Rate for Payer: Central Health Plan Commercial |
$76.00
|
| Rate for Payer: Cigna of CA HMO |
$60.80
|
| Rate for Payer: Cigna of CA PPO |
$70.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$80.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.00
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.00
|
| Rate for Payer: Galaxy Health WC |
$80.75
|
| Rate for Payer: Global Benefits Group Commercial |
$57.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$71.25
|
| Rate for Payer: IEHP medi-cal |
$33.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$63.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.00
|
| Rate for Payer: Multiplan Commercial |
$71.25
|
| Rate for Payer: Networks By Design Commercial |
$61.75
|
| Rate for Payer: Prime Health Services Commercial |
$80.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$57.00
|
| Rate for Payer: Riverside University Health MISP |
$38.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.50
|
| Rate for Payer: United Healthcare All Other HMO |
$47.50
|
| Rate for Payer: United Healthcare HMO Rider |
$47.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$80.75
|
| Rate for Payer: Vantage Medical Group Senior |
$80.75
|
|
|
HC SUTURE PROLENE 5-0 DBL ARM RB
|
Facility
IP
|
$36.65
|
|
| Hospital Charge Code |
901603043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$32.98 |
| Rate for Payer: Cash Price |
$16.49
|
| Rate for Payer: Central Health Plan Commercial |
$29.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.66
|
| Rate for Payer: Galaxy Health WC |
$31.15
|
| Rate for Payer: Global Benefits Group Commercial |
$21.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.33
|
| Rate for Payer: Multiplan Commercial |
$27.49
|
| Rate for Payer: Networks By Design Commercial |
$23.82
|
| Rate for Payer: Prime Health Services Commercial |
$31.15
|
|
|
HC SUTURE PROLENE 5-0 DBL ARM RB
|
Facility
OP
|
$36.65
|
|
| Hospital Charge Code |
901603043
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.33 |
| Max. Negotiated Rate |
$32.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22.26
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$31.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$20.16
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.16
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.65
|
| Rate for Payer: BCBS Transplant Transplant |
$21.99
|
| Rate for Payer: Blue Shield of California Commercial |
$23.05
|
| Rate for Payer: Blue Shield of California EPN |
$17.92
|
| Rate for Payer: Cash Price |
$16.49
|
| Rate for Payer: Central Health Plan Commercial |
$29.32
|
| Rate for Payer: Cigna of CA HMO |
$23.46
|
| Rate for Payer: Cigna of CA PPO |
$27.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$14.66
|
| Rate for Payer: Galaxy Health WC |
$31.15
|
| Rate for Payer: Global Benefits Group Commercial |
$21.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.98
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$27.49
|
| Rate for Payer: IEHP medi-cal |
$12.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.33
|
| Rate for Payer: Multiplan Commercial |
$27.49
|
| Rate for Payer: Networks By Design Commercial |
$23.82
|
| Rate for Payer: Prime Health Services Commercial |
$31.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$21.99
|
| Rate for Payer: Riverside University Health MISP |
$14.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.32
|
| Rate for Payer: United Healthcare All Other HMO |
$18.32
|
| Rate for Payer: United Healthcare HMO Rider |
$18.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.15
|
| Rate for Payer: Vantage Medical Group Senior |
$31.15
|
|
|
HC SUTURE PROLENE 6-0 18"
|
Facility
OP
|
$31.98
|
|
| Hospital Charge Code |
901603486
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.40 |
| Max. Negotiated Rate |
$28.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.18
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.89
|
| Rate for Payer: BCBS Transplant Transplant |
$19.19
|
| Rate for Payer: Blue Shield of California Commercial |
$20.12
|
| Rate for Payer: Blue Shield of California EPN |
$15.64
|
| Rate for Payer: Cash Price |
$14.39
|
| Rate for Payer: Central Health Plan Commercial |
$25.58
|
| Rate for Payer: Cigna of CA HMO |
$20.47
|
| Rate for Payer: Cigna of CA PPO |
$23.67
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.79
|
| Rate for Payer: Galaxy Health WC |
$27.18
|
| Rate for Payer: Global Benefits Group Commercial |
$19.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.78
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$23.98
|
| Rate for Payer: IEHP medi-cal |
$11.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.40
|
| Rate for Payer: Multiplan Commercial |
$23.98
|
| Rate for Payer: Networks By Design Commercial |
$20.79
|
| Rate for Payer: Prime Health Services Commercial |
$27.18
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19.19
|
| Rate for Payer: Riverside University Health MISP |
$12.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.99
|
| Rate for Payer: United Healthcare All Other HMO |
$15.99
|
| Rate for Payer: United Healthcare HMO Rider |
$15.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.18
|
| Rate for Payer: Vantage Medical Group Senior |
$27.18
|
|
