|
HC SUTURE SILK 3-0 108252
|
Facility
IP
|
$8.94
|
|
| Hospital Charge Code |
901694657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
|
|
HC SUTURE SILK 3-0 108252
|
Facility
OP
|
$8.94
|
|
| Hospital Charge Code |
901694657
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$1.79 |
| Max. Negotiated Rate |
$8.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.28
|
| Rate for Payer: BCBS Transplant Transplant |
$5.36
|
| Rate for Payer: Blue Shield of California Commercial |
$5.62
|
| Rate for Payer: Blue Shield of California EPN |
$4.37
|
| Rate for Payer: Cash Price |
$4.02
|
| Rate for Payer: Central Health Plan Commercial |
$7.15
|
| Rate for Payer: Cigna of CA HMO |
$5.72
|
| Rate for Payer: Cigna of CA PPO |
$6.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.58
|
| Rate for Payer: Galaxy Health WC |
$7.60
|
| Rate for Payer: Global Benefits Group Commercial |
$5.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.05
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.70
|
| Rate for Payer: IEHP medi-cal |
$3.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.79
|
| Rate for Payer: Multiplan Commercial |
$6.70
|
| Rate for Payer: Networks By Design Commercial |
$5.81
|
| Rate for Payer: Prime Health Services Commercial |
$7.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: Riverside University Health MISP |
$3.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.47
|
| Rate for Payer: United Healthcare All Other HMO |
$4.47
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.60
|
| Rate for Payer: Vantage Medical Group Senior |
$7.60
|
|
|
HC SUTURE SILK 3-0 18" FS-1
|
Facility
IP
|
$11.32
|
|
| Hospital Charge Code |
901604018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$10.19 |
| Rate for Payer: Cash Price |
$5.09
|
| Rate for Payer: Central Health Plan Commercial |
$9.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.53
|
| Rate for Payer: Galaxy Health WC |
$9.62
|
| Rate for Payer: Global Benefits Group Commercial |
$6.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.26
|
| Rate for Payer: Multiplan Commercial |
$8.49
|
| Rate for Payer: Networks By Design Commercial |
$7.36
|
| Rate for Payer: Prime Health Services Commercial |
$9.62
|
|
|
HC SUTURE SILK 3-0 18" FS-1
|
Facility
OP
|
$11.32
|
|
| Hospital Charge Code |
901604018
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$10.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.69
|
| Rate for Payer: BCBS Transplant Transplant |
$6.79
|
| Rate for Payer: Blue Shield of California Commercial |
$7.12
|
| Rate for Payer: Blue Shield of California EPN |
$5.54
|
| Rate for Payer: Cash Price |
$5.09
|
| Rate for Payer: Central Health Plan Commercial |
$9.06
|
| Rate for Payer: Cigna of CA HMO |
$7.24
|
| Rate for Payer: Cigna of CA PPO |
$8.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.53
|
| Rate for Payer: Galaxy Health WC |
$9.62
|
| Rate for Payer: Global Benefits Group Commercial |
$6.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.19
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.49
|
| Rate for Payer: IEHP medi-cal |
$3.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.26
|
| Rate for Payer: Multiplan Commercial |
$8.49
|
| Rate for Payer: Networks By Design Commercial |
$7.36
|
| Rate for Payer: Prime Health Services Commercial |
$9.62
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.79
|
| Rate for Payer: Riverside University Health MISP |
$4.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.66
|
| Rate for Payer: United Healthcare All Other HMO |
$5.66
|
| Rate for Payer: United Healthcare HMO Rider |
$5.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.62
|
| Rate for Payer: Vantage Medical Group Senior |
$9.62
|
|
|
HC SUTURE SILK 3-0 18" PS-2
|
Facility
IP
|
$23.94
|
|
| Hospital Charge Code |
901604404
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$21.55 |
| Rate for Payer: Cash Price |
$10.77
|
| Rate for Payer: Central Health Plan Commercial |
$19.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.58
|
| Rate for Payer: Galaxy Health WC |
$20.35
|
| Rate for Payer: Global Benefits Group Commercial |
$14.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.79
|
| Rate for Payer: Multiplan Commercial |
$17.96
|
| Rate for Payer: Networks By Design Commercial |
$15.56
|
| Rate for Payer: Prime Health Services Commercial |
$20.35
|
|
|
HC SUTURE SILK 3-0 18" PS-2
|
Facility
OP
|
$23.94
|
|
| Hospital Charge Code |
901604404
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$21.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.14
|
| Rate for Payer: BCBS Transplant Transplant |
$14.36
|
| Rate for Payer: Blue Shield of California Commercial |
$15.06
|
| Rate for Payer: Blue Shield of California EPN |
$11.71
|
| Rate for Payer: Cash Price |
$10.77
|
| Rate for Payer: Central Health Plan Commercial |
$19.15
|
| Rate for Payer: Cigna of CA HMO |
$15.32
|
| Rate for Payer: Cigna of CA PPO |
$17.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.58
|
| Rate for Payer: Galaxy Health WC |
$20.35
|
| Rate for Payer: Global Benefits Group Commercial |
$14.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.55
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$17.96
|
| Rate for Payer: IEHP medi-cal |
$8.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.79
|
| Rate for Payer: Multiplan Commercial |
$17.96
|
| Rate for Payer: Networks By Design Commercial |
$15.56
|
| Rate for Payer: Prime Health Services Commercial |
$20.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$14.36
|
| Rate for Payer: Riverside University Health MISP |
$9.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.97
|
| Rate for Payer: United Healthcare All Other HMO |
$11.97
|
| Rate for Payer: United Healthcare HMO Rider |
$11.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.35
|
| Rate for Payer: Vantage Medical Group Senior |
$20.35
|
|
|
HC SUTURE SILK 3-0 24"
|
Facility
OP
|
$16.89
|
|
| Hospital Charge Code |
901601278
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$15.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.26
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.36
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.29
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.98
|
| Rate for Payer: BCBS Transplant Transplant |
$10.13
|
| Rate for Payer: Blue Shield of California Commercial |
$10.62
|
| Rate for Payer: Blue Shield of California EPN |
$8.26
|
| Rate for Payer: Cash Price |
$7.60
|
| Rate for Payer: Central Health Plan Commercial |
$13.51
|
| Rate for Payer: Cigna of CA HMO |
$10.81
|
| Rate for Payer: Cigna of CA PPO |
$12.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.76
|
| Rate for Payer: Galaxy Health WC |
$14.36
|
| Rate for Payer: Global Benefits Group Commercial |
$10.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.67
|
| Rate for Payer: IEHP medi-cal |
$5.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.38
|
| Rate for Payer: Multiplan Commercial |
$12.67
|
| Rate for Payer: Networks By Design Commercial |
$10.98
|
| Rate for Payer: Prime Health Services Commercial |
$14.36
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$10.13
|
| Rate for Payer: Riverside University Health MISP |
$6.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.44
|
| Rate for Payer: United Healthcare All Other HMO |
$8.44
|
| Rate for Payer: United Healthcare HMO Rider |
$8.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.36
|
| Rate for Payer: Vantage Medical Group Senior |
$14.36
|
|
|
HC SUTURE SILK 3-0 24"
|
Facility
IP
|
$16.89
|
|
| Hospital Charge Code |
901601278
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.38 |
| Max. Negotiated Rate |
$15.20 |
| Rate for Payer: Cash Price |
$7.60
|
| Rate for Payer: Central Health Plan Commercial |
$13.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.76
|
| Rate for Payer: Galaxy Health WC |
$14.36
|
| Rate for Payer: Global Benefits Group Commercial |
$10.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.38
|
| Rate for Payer: Multiplan Commercial |
$12.67
|
| Rate for Payer: Networks By Design Commercial |
$10.98
|
| Rate for Payer: Prime Health Services Commercial |
$14.36
|
|
|
HC SUTURE SILK 3-0 30" BRD
|
Facility
OP
|
$12.05
|
|
| Hospital Charge Code |
901693130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$10.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.32
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.12
|
| Rate for Payer: BCBS Transplant Transplant |
$7.23
|
| Rate for Payer: Blue Shield of California Commercial |
$7.58
|
| Rate for Payer: Blue Shield of California EPN |
$5.89
|
| Rate for Payer: Cash Price |
$5.42
|
| Rate for Payer: Central Health Plan Commercial |
$9.64
|
| Rate for Payer: Cigna of CA HMO |
$7.71
|
| Rate for Payer: Cigna of CA PPO |
$8.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.84
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.04
|
| Rate for Payer: IEHP medi-cal |
$4.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.41
|
| Rate for Payer: Multiplan Commercial |
$9.04
|
| Rate for Payer: Networks By Design Commercial |
$7.83
|
| Rate for Payer: Prime Health Services Commercial |
$10.24
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.23
|
| Rate for Payer: Riverside University Health MISP |
$4.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.02
|
| Rate for Payer: United Healthcare All Other HMO |
$6.02
|
| Rate for Payer: United Healthcare HMO Rider |
$6.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.24
|
| Rate for Payer: Vantage Medical Group Senior |
$10.24
|
|
|
HC SUTURE SILK 3-0 30" BRD
|
Facility
IP
|
$12.05
|
|
| Hospital Charge Code |
901693130
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.41 |
| Max. Negotiated Rate |
$10.84 |
| Rate for Payer: Cash Price |
$5.42
|
| Rate for Payer: Central Health Plan Commercial |
$9.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.41
|
| Rate for Payer: Multiplan Commercial |
$9.04
|
| Rate for Payer: Networks By Design Commercial |
$7.83
|
| Rate for Payer: Prime Health Services Commercial |
$10.24
|
|
|
HC SUTURE SILK 3-0 BR 299391
|
Facility
IP
|
$12.63
|
|
| Hospital Charge Code |
901693132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$11.37 |
| Rate for Payer: Cash Price |
$5.68
|
| Rate for Payer: Central Health Plan Commercial |
$10.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.05
|
| Rate for Payer: Galaxy Health WC |
$10.74
|
| Rate for Payer: Global Benefits Group Commercial |
$7.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.53
|
| Rate for Payer: Multiplan Commercial |
$9.47
|
| Rate for Payer: Networks By Design Commercial |
$8.21
|
| Rate for Payer: Prime Health Services Commercial |
$10.74
|
|
|
HC SUTURE SILK 3-0 BR 299391
|
Facility
OP
|
$12.63
|
|
| Hospital Charge Code |
901693132
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$11.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.74
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.46
|
| Rate for Payer: BCBS Transplant Transplant |
$7.58
|
| Rate for Payer: Blue Shield of California Commercial |
$7.94
|
| Rate for Payer: Blue Shield of California EPN |
$6.18
|
| Rate for Payer: Cash Price |
$5.68
|
| Rate for Payer: Central Health Plan Commercial |
$10.10
|
| Rate for Payer: Cigna of CA HMO |
$8.08
|
| Rate for Payer: Cigna of CA PPO |
$9.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.05
|
| Rate for Payer: Galaxy Health WC |
$10.74
|
| Rate for Payer: Global Benefits Group Commercial |
$7.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.37
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.47
|
| Rate for Payer: IEHP medi-cal |
$4.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.53
|
| Rate for Payer: Multiplan Commercial |
$9.47
|
| Rate for Payer: Networks By Design Commercial |
$8.21
|
| Rate for Payer: Prime Health Services Commercial |
$10.74
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.58
|
| Rate for Payer: Riverside University Health MISP |
$5.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.32
|
| Rate for Payer: United Healthcare All Other HMO |
$6.32
|
| Rate for Payer: United Healthcare HMO Rider |
$6.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.74
|
| Rate for Payer: Vantage Medical Group Senior |
$10.74
|
|
|
HC SUTURE SILK 4-0 18" C-3
|
Facility
OP
|
$13.20
|
|
| Hospital Charge Code |
901604353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$11.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.80
|
| Rate for Payer: BCBS Transplant Transplant |
$7.92
|
| Rate for Payer: Blue Shield of California Commercial |
$8.30
|
| Rate for Payer: Blue Shield of California EPN |
$6.45
|
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Central Health Plan Commercial |
$10.56
|
| Rate for Payer: Cigna of CA HMO |
$8.45
|
| Rate for Payer: Cigna of CA PPO |
$9.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.28
|
| Rate for Payer: Galaxy Health WC |
$11.22
|
| Rate for Payer: Global Benefits Group Commercial |
$7.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.88
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.90
|
| Rate for Payer: IEHP medi-cal |
$4.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.64
|
| Rate for Payer: Multiplan Commercial |
$9.90
|
| Rate for Payer: Networks By Design Commercial |
$8.58
|
| Rate for Payer: Prime Health Services Commercial |
$11.22
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.92
|
| Rate for Payer: Riverside University Health MISP |
$5.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.60
|
| Rate for Payer: United Healthcare All Other HMO |
$6.60
|
| Rate for Payer: United Healthcare HMO Rider |
$6.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.22
|
| Rate for Payer: Vantage Medical Group Senior |
$11.22
|
|
|
HC SUTURE SILK 4-0 18" C-3
|
Facility
IP
|
$13.20
|
|
| Hospital Charge Code |
901604353
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.64 |
| Max. Negotiated Rate |
$11.88 |
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Central Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
| Rate for Payer: Galaxy Health WC |
$11.22
|
| Rate for Payer: Global Benefits Group Commercial |
$7.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.64
|
| Rate for Payer: Multiplan Commercial |
$9.90
|
| Rate for Payer: Networks By Design Commercial |
$8.58
|
| Rate for Payer: Prime Health Services Commercial |
$11.22
|
|
|
HC SUTURE SILK 4-0 18" FS-2
|
Facility
OP
|
$11.32
|
|
| Hospital Charge Code |
901601280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$10.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.69
|
| Rate for Payer: BCBS Transplant Transplant |
$6.79
|
| Rate for Payer: Blue Shield of California Commercial |
$7.12
|
| Rate for Payer: Blue Shield of California EPN |
$5.54
|
| Rate for Payer: Cash Price |
$5.09
|
| Rate for Payer: Central Health Plan Commercial |
$9.06
|
| Rate for Payer: Cigna of CA HMO |
$7.24
|
| Rate for Payer: Cigna of CA PPO |
$8.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.53
|
| Rate for Payer: Galaxy Health WC |
$9.62
|
| Rate for Payer: Global Benefits Group Commercial |
$6.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.19
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.49
|
| Rate for Payer: IEHP medi-cal |
$3.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.26
|
| Rate for Payer: Multiplan Commercial |
$8.49
|
| Rate for Payer: Networks By Design Commercial |
$7.36
|
| Rate for Payer: Prime Health Services Commercial |
$9.62
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.79
|
| Rate for Payer: Riverside University Health MISP |
$4.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.66
|
| Rate for Payer: United Healthcare All Other HMO |
$5.66
|
| Rate for Payer: United Healthcare HMO Rider |
$5.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.62
|
| Rate for Payer: Vantage Medical Group Senior |
$9.62
|
|
|
HC SUTURE SILK 4-0 18" FS-2
|
Facility
IP
|
$11.32
|
|
| Hospital Charge Code |
901601280
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.26 |
| Max. Negotiated Rate |
$10.19 |
| Rate for Payer: Cash Price |
$5.09
|
| Rate for Payer: Central Health Plan Commercial |
$9.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.53
|
| Rate for Payer: Galaxy Health WC |
$9.62
|
| Rate for Payer: Global Benefits Group Commercial |
$6.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.26
|
| Rate for Payer: Multiplan Commercial |
$8.49
|
| Rate for Payer: Networks By Design Commercial |
$7.36
|
| Rate for Payer: Prime Health Services Commercial |
$9.62
|
|
|
HC SUTURE SILK 4-0 24"
|
Facility
IP
|
$15.99
|
|
| Hospital Charge Code |
901604349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$14.39 |
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Central Health Plan Commercial |
$12.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.40
|
| Rate for Payer: Galaxy Health WC |
$13.59
|
| Rate for Payer: Global Benefits Group Commercial |
$9.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.20
|
| Rate for Payer: Multiplan Commercial |
$11.99
|
| Rate for Payer: Networks By Design Commercial |
$10.39
|
| Rate for Payer: Prime Health Services Commercial |
$13.59
|
|
|
HC SUTURE SILK 4-0 24"
|
Facility
OP
|
$15.99
|
|
| Hospital Charge Code |
901604349
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.20 |
| Max. Negotiated Rate |
$14.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.59
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.79
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.45
|
| Rate for Payer: BCBS Transplant Transplant |
$9.59
|
| Rate for Payer: Blue Shield of California Commercial |
$10.06
|
| Rate for Payer: Blue Shield of California EPN |
$7.82
|
| Rate for Payer: Cash Price |
$7.20
|
| Rate for Payer: Central Health Plan Commercial |
$12.79
|
| Rate for Payer: Cigna of CA HMO |
$10.23
|
| Rate for Payer: Cigna of CA PPO |
$11.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.40
|
| Rate for Payer: Galaxy Health WC |
$13.59
|
| Rate for Payer: Global Benefits Group Commercial |
$9.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.39
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11.99
|
| Rate for Payer: IEHP medi-cal |
$5.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.20
|
| Rate for Payer: Multiplan Commercial |
$11.99
|
| Rate for Payer: Networks By Design Commercial |
$10.39
|
| Rate for Payer: Prime Health Services Commercial |
$13.59
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.59
|
| Rate for Payer: Riverside University Health MISP |
$6.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.59
|
| Rate for Payer: Vantage Medical Group Senior |
$13.59
|
|
|
HC SUTURE VICRYL 0 100426
|
Facility
OP
|
$12.38
|
|
| Hospital Charge Code |
901693114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$11.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.81
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.31
|
| Rate for Payer: BCBS Transplant Transplant |
$7.43
|
| Rate for Payer: Blue Shield of California Commercial |
$7.79
|
| Rate for Payer: Blue Shield of California EPN |
$6.05
|
| Rate for Payer: Cash Price |
$5.57
|
| Rate for Payer: Central Health Plan Commercial |
$9.90
|
| Rate for Payer: Cigna of CA HMO |
$7.92
|
| Rate for Payer: Cigna of CA PPO |
$9.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.95
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.95
|
| Rate for Payer: Galaxy Health WC |
$10.52
|
| Rate for Payer: Global Benefits Group Commercial |
$7.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.14
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.28
|
| Rate for Payer: IEHP medi-cal |
$4.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.48
|
| Rate for Payer: Multiplan Commercial |
$9.28
|
| Rate for Payer: Networks By Design Commercial |
$8.05
|
| Rate for Payer: Prime Health Services Commercial |
$10.52
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.43
|
| Rate for Payer: Riverside University Health MISP |
$4.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.19
|
| Rate for Payer: United Healthcare All Other HMO |
$6.19
|
| Rate for Payer: United Healthcare HMO Rider |
$6.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.52
|
| Rate for Payer: Vantage Medical Group Senior |
$10.52
|
|
|
HC SUTURE VICRYL 0 100426
|
Facility
IP
|
$12.38
|
|
| Hospital Charge Code |
901693114
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$11.14 |
| Rate for Payer: Cash Price |
$5.57
|
| Rate for Payer: Central Health Plan Commercial |
$9.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.95
|
| Rate for Payer: Galaxy Health WC |
$10.52
|
| Rate for Payer: Global Benefits Group Commercial |
$7.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.48
|
| Rate for Payer: Multiplan Commercial |
$9.28
|
| Rate for Payer: Networks By Design Commercial |
$8.05
|
| Rate for Payer: Prime Health Services Commercial |
$10.52
|
|
|
HC SUTURE VICRYL 0 27"
|
Facility
IP
|
$14.30
|
|
| Hospital Charge Code |
901693116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$12.87 |
| Rate for Payer: Cash Price |
$6.44
|
| Rate for Payer: Central Health Plan Commercial |
$11.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.72
|
| Rate for Payer: Galaxy Health WC |
$12.16
|
| Rate for Payer: Global Benefits Group Commercial |
$8.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.86
|
| Rate for Payer: Multiplan Commercial |
$10.72
|
| Rate for Payer: Networks By Design Commercial |
$9.30
|
| Rate for Payer: Prime Health Services Commercial |
$12.16
|
|
|
HC SUTURE VICRYL 0 27"
|
Facility
OP
|
$14.30
|
|
| Hospital Charge Code |
901693116
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.86 |
| Max. Negotiated Rate |
$12.87 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.16
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.45
|
| Rate for Payer: BCBS Transplant Transplant |
$8.58
|
| Rate for Payer: Blue Shield of California Commercial |
$8.99
|
| Rate for Payer: Blue Shield of California EPN |
$6.99
|
| Rate for Payer: Cash Price |
$6.44
|
| Rate for Payer: Central Health Plan Commercial |
$11.44
|
| Rate for Payer: Cigna of CA HMO |
$9.15
|
| Rate for Payer: Cigna of CA PPO |
$10.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.72
|
| Rate for Payer: Galaxy Health WC |
$12.16
|
| Rate for Payer: Global Benefits Group Commercial |
$8.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.87
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.72
|
| Rate for Payer: IEHP medi-cal |
$5.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.86
|
| Rate for Payer: Multiplan Commercial |
$10.72
|
| Rate for Payer: Networks By Design Commercial |
$9.30
|
| Rate for Payer: Prime Health Services Commercial |
$12.16
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.58
|
| Rate for Payer: Riverside University Health MISP |
$5.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.58
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.15
|
| Rate for Payer: United Healthcare All Other HMO |
$7.15
|
| Rate for Payer: United Healthcare HMO Rider |
$7.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.16
|
| Rate for Payer: Vantage Medical Group Senior |
$12.16
|
|
|
HC SUTURE VICRYL 0 27" 101315
|
Facility
OP
|
$11.97
|
|
| Hospital Charge Code |
901694619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$10.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.27
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.17
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.07
|
| Rate for Payer: BCBS Transplant Transplant |
$7.18
|
| Rate for Payer: Blue Shield of California Commercial |
$7.53
|
| Rate for Payer: Blue Shield of California EPN |
$5.85
|
| Rate for Payer: Cash Price |
$5.39
|
| Rate for Payer: Central Health Plan Commercial |
$9.58
|
| Rate for Payer: Cigna of CA HMO |
$7.66
|
| Rate for Payer: Cigna of CA PPO |
$8.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.79
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.79
|
| Rate for Payer: Galaxy Health WC |
$10.17
|
| Rate for Payer: Global Benefits Group Commercial |
$7.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.77
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.98
|
| Rate for Payer: IEHP medi-cal |
$4.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.39
|
| Rate for Payer: Multiplan Commercial |
$8.98
|
| Rate for Payer: Networks By Design Commercial |
$7.78
|
| Rate for Payer: Prime Health Services Commercial |
$10.17
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.18
|
| Rate for Payer: Riverside University Health MISP |
$4.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.98
|
| Rate for Payer: United Healthcare All Other HMO |
$5.98
|
| Rate for Payer: United Healthcare HMO Rider |
$5.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.17
|
| Rate for Payer: Vantage Medical Group Senior |
$10.17
|
|
|
HC SUTURE VICRYL 0 27" 101315
|
Facility
IP
|
$11.97
|
|
| Hospital Charge Code |
901694619
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.39 |
| Max. Negotiated Rate |
$10.77 |
| Rate for Payer: Cash Price |
$5.39
|
| Rate for Payer: Central Health Plan Commercial |
$9.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.79
|
| Rate for Payer: Galaxy Health WC |
$10.17
|
| Rate for Payer: Global Benefits Group Commercial |
$7.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.39
|
| Rate for Payer: Multiplan Commercial |
$8.98
|
| Rate for Payer: Networks By Design Commercial |
$7.78
|
| Rate for Payer: Prime Health Services Commercial |
$10.17
|
|
|
HC SUTURE VICRYL 0 54"BR 100304
|
Facility
OP
|
$14.10
|
|
| Hospital Charge Code |
901694608
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.82 |
| Max. Negotiated Rate |
$12.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.56
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.76
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.33
|
| Rate for Payer: BCBS Transplant Transplant |
$8.46
|
| Rate for Payer: Blue Shield of California Commercial |
$8.87
|
| Rate for Payer: Blue Shield of California EPN |
$6.89
|
| Rate for Payer: Cash Price |
$6.35
|
| Rate for Payer: Central Health Plan Commercial |
$11.28
|
| Rate for Payer: Cigna of CA HMO |
$9.02
|
| Rate for Payer: Cigna of CA PPO |
$10.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.64
|
| Rate for Payer: Galaxy Health WC |
$11.98
|
| Rate for Payer: Global Benefits Group Commercial |
$8.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.69
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.58
|
| Rate for Payer: IEHP medi-cal |
$4.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.82
|
| Rate for Payer: Multiplan Commercial |
$10.58
|
| Rate for Payer: Networks By Design Commercial |
$9.16
|
| Rate for Payer: Prime Health Services Commercial |
$11.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.46
|
| Rate for Payer: Riverside University Health MISP |
$5.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.05
|
| Rate for Payer: United Healthcare All Other HMO |
$7.05
|
| Rate for Payer: United Healthcare HMO Rider |
$7.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.98
|
| Rate for Payer: Vantage Medical Group Senior |
$11.98
|
|
