|
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
|
|
|
HC SUTURE VICRYL 0 CR 104520
|
Facility
OP
|
$11.73
|
|
| Hospital Charge Code |
901693127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.45
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.93
|
| Rate for Payer: BCBS Transplant Transplant |
$7.04
|
| Rate for Payer: Blue Shield of California Commercial |
$7.38
|
| Rate for Payer: Blue Shield of California EPN |
$5.74
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: Cigna of CA HMO |
$7.51
|
| Rate for Payer: Cigna of CA PPO |
$8.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.80
|
| Rate for Payer: IEHP medi-cal |
$4.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.04
|
| Rate for Payer: Riverside University Health MISP |
$4.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.86
|
| Rate for Payer: United Healthcare All Other HMO |
$5.86
|
| Rate for Payer: United Healthcare HMO Rider |
$5.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.97
|
| Rate for Payer: Vantage Medical Group Senior |
$9.97
|
|
|
HC SUTURE VICRYL 0 CR 104520
|
Facility
IP
|
$11.73
|
|
| Hospital Charge Code |
901693127
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.35 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Central Health Plan Commercial |
$9.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.69
|
| Rate for Payer: Galaxy Health WC |
$9.97
|
| Rate for Payer: Global Benefits Group Commercial |
$7.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.35
|
| Rate for Payer: Multiplan Commercial |
$8.80
|
| Rate for Payer: Networks By Design Commercial |
$7.62
|
| Rate for Payer: Prime Health Services Commercial |
$9.97
|
|
|
HC SUTURE VICRYL 0 CT-2 103660
|
Facility
OP
|
$12.38
|
|
| Hospital Charge Code |
901694872
|
|
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 CT-2 103660
|
Facility
IP
|
$12.38
|
|
| Hospital Charge Code |
901694872
|
|
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 1-0 102831
|
Facility
IP
|
$10.66
|
|
| Hospital Charge Code |
901694618
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$9.59 |
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Central Health Plan Commercial |
$8.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.26
|
| Rate for Payer: Galaxy Health WC |
$9.06
|
| Rate for Payer: Global Benefits Group Commercial |
$6.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.13
|
| Rate for Payer: Multiplan Commercial |
$8.00
|
| Rate for Payer: Networks By Design Commercial |
$6.93
|
| Rate for Payer: Prime Health Services Commercial |
$9.06
|
|
|
HC SUTURE VICRYL 1-0 102831
|
Facility
OP
|
$10.66
|
|
| Hospital Charge Code |
901694618
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.13 |
| Max. Negotiated Rate |
$9.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.30
|
| Rate for Payer: BCBS Transplant Transplant |
$6.40
|
| Rate for Payer: Blue Shield of California Commercial |
$6.71
|
| Rate for Payer: Blue Shield of California EPN |
$5.21
|
| Rate for Payer: Cash Price |
$4.80
|
| Rate for Payer: Central Health Plan Commercial |
$8.53
|
| Rate for Payer: Cigna of CA HMO |
$6.82
|
| Rate for Payer: Cigna of CA PPO |
$7.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.26
|
| Rate for Payer: Galaxy Health WC |
$9.06
|
| Rate for Payer: Global Benefits Group Commercial |
$6.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.59
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.00
|
| Rate for Payer: IEHP medi-cal |
$3.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.13
|
| Rate for Payer: Multiplan Commercial |
$8.00
|
| Rate for Payer: Networks By Design Commercial |
$6.93
|
| Rate for Payer: Prime Health Services Commercial |
$9.06
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.40
|
| Rate for Payer: Riverside University Health MISP |
$4.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.33
|
| Rate for Payer: United Healthcare All Other HMO |
$5.33
|
| Rate for Payer: United Healthcare HMO Rider |
$5.33
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.06
|
| Rate for Payer: Vantage Medical Group Senior |
$9.06
|
|
|
HC SUTURE VICRYL 1-0 218854
|
Facility
OP
|
$13.36
|
|
| Hospital Charge Code |
901693125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$12.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.36
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.35
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.89
|
| Rate for Payer: BCBS Transplant Transplant |
$8.02
|
| Rate for Payer: Blue Shield of California Commercial |
$8.40
|
| Rate for Payer: Blue Shield of California EPN |
$6.53
|
| Rate for Payer: Cash Price |
$6.01
|
| Rate for Payer: Central Health Plan Commercial |
$10.69
|
| Rate for Payer: Cigna of CA HMO |
$8.55
|
| Rate for Payer: Cigna of CA PPO |
$9.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.34
|
| Rate for Payer: Galaxy Health WC |
$11.36
|
| Rate for Payer: Global Benefits Group Commercial |
$8.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.02
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.02
|
| Rate for Payer: IEHP medi-cal |
$4.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.67
|
| Rate for Payer: Multiplan Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$8.68
|
| Rate for Payer: Prime Health Services Commercial |
$11.36
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.02
|
| Rate for Payer: Riverside University Health MISP |
$5.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.68
|
| Rate for Payer: United Healthcare All Other HMO |
$6.68
|
| Rate for Payer: United Healthcare HMO Rider |
$6.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.36
|
| Rate for Payer: Vantage Medical Group Senior |
$11.36
|
|
|
HC SUTURE VICRYL 1-0 218854
|
Facility
IP
|
$13.36
|
|
| Hospital Charge Code |
901693125
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$12.02 |
| Rate for Payer: Cash Price |
$6.01
|
| Rate for Payer: Central Health Plan Commercial |
$10.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.34
|
| Rate for Payer: Galaxy Health WC |
$11.36
|
| Rate for Payer: Global Benefits Group Commercial |
$8.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.67
|
| Rate for Payer: Multiplan Commercial |
$10.02
|
| Rate for Payer: Networks By Design Commercial |
$8.68
|
| Rate for Payer: Prime Health Services Commercial |
$11.36
|
|
|
HC SUTURE VICRYL 1-0 27" BR
|
Facility
IP
|
$12.30
|
|
| Hospital Charge Code |
901601960
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Cash Price |
$5.54
|
| Rate for Payer: Central Health Plan Commercial |
$9.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.92
|
| Rate for Payer: Galaxy Health WC |
$10.46
|
| Rate for Payer: Global Benefits Group Commercial |
$7.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.46
|
| Rate for Payer: Multiplan Commercial |
$9.22
|
| Rate for Payer: Networks By Design Commercial |
$8.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.46
|
|
|
HC SUTURE VICRYL 1-0 27" BR
|
Facility
OP
|
$12.30
|
|
| Hospital Charge Code |
901601960
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.46 |
| Max. Negotiated Rate |
$11.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.76
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.27
|
| Rate for Payer: BCBS Transplant Transplant |
$7.38
|
| Rate for Payer: Blue Shield of California Commercial |
$7.74
|
| Rate for Payer: Blue Shield of California EPN |
$6.01
|
| Rate for Payer: Cash Price |
$5.54
|
| Rate for Payer: Central Health Plan Commercial |
$9.84
|
| Rate for Payer: Cigna of CA HMO |
$7.87
|
| Rate for Payer: Cigna of CA PPO |
$9.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.92
|
| Rate for Payer: Galaxy Health WC |
$10.46
|
| Rate for Payer: Global Benefits Group Commercial |
$7.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.07
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.22
|
| Rate for Payer: IEHP medi-cal |
$4.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.46
|
| Rate for Payer: Multiplan Commercial |
$9.22
|
| Rate for Payer: Networks By Design Commercial |
$8.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.46
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.38
|
| Rate for Payer: Riverside University Health MISP |
$4.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.15
|
| Rate for Payer: United Healthcare All Other HMO |
$6.15
|
| Rate for Payer: United Healthcare HMO Rider |
$6.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.46
|
| Rate for Payer: Vantage Medical Group Senior |
$10.46
|
|
|
HC SUTURE VICRYL+ 1-0 ANTIBC
|
Facility
OP
|
$13.12
|
|
| Hospital Charge Code |
901693108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$11.81 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.97
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.22
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.35
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.75
|
| Rate for Payer: BCBS Transplant Transplant |
$7.87
|
| Rate for Payer: Blue Shield of California Commercial |
$8.25
|
| Rate for Payer: Blue Shield of California EPN |
$6.42
|
| Rate for Payer: Cash Price |
$5.90
|
| Rate for Payer: Central Health Plan Commercial |
$10.50
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$9.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.25
|
| Rate for Payer: Galaxy Health WC |
$11.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.81
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.84
|
| Rate for Payer: IEHP medi-cal |
$4.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.62
|
| Rate for Payer: Multiplan Commercial |
$9.84
|
| Rate for Payer: Networks By Design Commercial |
$8.53
|
| Rate for Payer: Prime Health Services Commercial |
$11.15
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.87
|
| Rate for Payer: Riverside University Health MISP |
$5.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.56
|
| Rate for Payer: United Healthcare All Other HMO |
$6.56
|
| Rate for Payer: United Healthcare HMO Rider |
$6.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.15
|
| Rate for Payer: Vantage Medical Group Senior |
$11.15
|
|
|
HC SUTURE VICRYL+ 1-0 ANTIBC
|
Facility
IP
|
$13.12
|
|
| Hospital Charge Code |
901693108
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.62 |
| Max. Negotiated Rate |
$11.81 |
| Rate for Payer: Cash Price |
$5.90
|
| Rate for Payer: Central Health Plan Commercial |
$10.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.25
|
| Rate for Payer: Galaxy Health WC |
$11.15
|
| Rate for Payer: Global Benefits Group Commercial |
$7.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.62
|
| Rate for Payer: Multiplan Commercial |
$9.84
|
| Rate for Payer: Networks By Design Commercial |
$8.53
|
| Rate for Payer: Prime Health Services Commercial |
$11.15
|
|
|
HC SUTURE VICRYL 1-0 CT BR100074
|
Facility
IP
|
$11.32
|
|
| Hospital Charge Code |
901694877
|
|
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 VICRYL 1-0 CT BR100074
|
Facility
OP
|
$11.32
|
|
| Hospital Charge Code |
901694877
|
|
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 VICRYL 1-0 CTX 140477
|
Facility
OP
|
$41.08
|
|
| Hospital Charge Code |
901694878
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.22 |
| Max. Negotiated Rate |
$36.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24.95
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$34.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.59
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$22.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$24.27
|
| Rate for Payer: BCBS Transplant Transplant |
$24.65
|
| Rate for Payer: Blue Shield of California Commercial |
$25.84
|
| Rate for Payer: Blue Shield of California EPN |
$20.09
|
| Rate for Payer: Cash Price |
$18.49
|
| Rate for Payer: Central Health Plan Commercial |
$32.86
|
| Rate for Payer: Cigna of CA HMO |
$26.29
|
| Rate for Payer: Cigna of CA PPO |
$30.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$16.43
|
| Rate for Payer: Galaxy Health WC |
$34.92
|
| Rate for Payer: Global Benefits Group Commercial |
$24.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.97
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$30.81
|
| Rate for Payer: IEHP medi-cal |
$14.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.22
|
| Rate for Payer: Multiplan Commercial |
$30.81
|
| Rate for Payer: Networks By Design Commercial |
$26.70
|
| Rate for Payer: Prime Health Services Commercial |
$34.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$24.65
|
| Rate for Payer: Riverside University Health MISP |
$16.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.54
|
| Rate for Payer: United Healthcare All Other HMO |
$20.54
|
| Rate for Payer: United Healthcare HMO Rider |
$20.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$20.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.92
|
| Rate for Payer: Vantage Medical Group Senior |
$34.92
|
|
|
HC SUTURE VICRYL 1-0 CTX 140477
|
Facility
IP
|
$41.08
|
|
| Hospital Charge Code |
901694878
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.22 |
| Max. Negotiated Rate |
$36.97 |
| Rate for Payer: Cash Price |
$18.49
|
| Rate for Payer: Central Health Plan Commercial |
$32.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.43
|
| Rate for Payer: Galaxy Health WC |
$34.92
|
| Rate for Payer: Global Benefits Group Commercial |
$24.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$36.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$27.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.22
|
| Rate for Payer: Multiplan Commercial |
$30.81
|
| Rate for Payer: Networks By Design Commercial |
$26.70
|
| Rate for Payer: Prime Health Services Commercial |
$34.92
|
|
|
HC SUTURE VICRYL 2-0 229392
|
Facility
OP
|
$12.22
|
|
| Hospital Charge Code |
901693131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$11.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.22
|
| Rate for Payer: BCBS Transplant Transplant |
$7.33
|
| Rate for Payer: Blue Shield of California Commercial |
$7.69
|
| Rate for Payer: Blue Shield of California EPN |
$5.98
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Central Health Plan Commercial |
$9.78
|
| Rate for Payer: Cigna of CA HMO |
$7.82
|
| Rate for Payer: Cigna of CA PPO |
$9.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.89
|
| Rate for Payer: Galaxy Health WC |
$10.39
|
| Rate for Payer: Global Benefits Group Commercial |
$7.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.16
|
| Rate for Payer: IEHP medi-cal |
$4.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.44
|
| Rate for Payer: Multiplan Commercial |
$9.16
|
| Rate for Payer: Networks By Design Commercial |
$7.94
|
| Rate for Payer: Prime Health Services Commercial |
$10.39
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.33
|
| Rate for Payer: Riverside University Health MISP |
$4.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.11
|
| Rate for Payer: United Healthcare All Other HMO |
$6.11
|
| Rate for Payer: United Healthcare HMO Rider |
$6.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.39
|
| Rate for Payer: Vantage Medical Group Senior |
$10.39
|
|
|
HC SUTURE VICRYL 2-0 229392
|
Facility
IP
|
$12.22
|
|
| Hospital Charge Code |
901693131
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$11.00 |
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Central Health Plan Commercial |
$9.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.89
|
| Rate for Payer: Galaxy Health WC |
$10.39
|
| Rate for Payer: Global Benefits Group Commercial |
$7.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.44
|
| Rate for Payer: Multiplan Commercial |
$9.16
|
| Rate for Payer: Networks By Design Commercial |
$7.94
|
| Rate for Payer: Prime Health Services Commercial |
$10.39
|
|
|
HC SUTURE VICRYL 2-0 27" CP-1
|
Facility
OP
|
$12.87
|
|
| Hospital Charge Code |
901604231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$11.58 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.82
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.08
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.08
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.60
|
| Rate for Payer: BCBS Transplant Transplant |
$7.72
|
| Rate for Payer: Blue Shield of California Commercial |
$8.10
|
| Rate for Payer: Blue Shield of California EPN |
$6.29
|
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Central Health Plan Commercial |
$10.30
|
| Rate for Payer: Cigna of CA HMO |
$8.24
|
| Rate for Payer: Cigna of CA PPO |
$9.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.58
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.65
|
| Rate for Payer: IEHP medi-cal |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.57
|
| Rate for Payer: Multiplan Commercial |
$9.65
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.72
|
| Rate for Payer: Riverside University Health MISP |
$5.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.44
|
| Rate for Payer: United Healthcare All Other HMO |
$6.44
|
| Rate for Payer: United Healthcare HMO Rider |
$6.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.94
|
| Rate for Payer: Vantage Medical Group Senior |
$10.94
|
|
|
HC SUTURE VICRYL 2-0 27" CP-1
|
Facility
IP
|
$12.87
|
|
| Hospital Charge Code |
901604231
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.57 |
| Max. Negotiated Rate |
$11.58 |
| Rate for Payer: Cash Price |
$5.79
|
| Rate for Payer: Central Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$10.94
|
| Rate for Payer: Global Benefits Group Commercial |
$7.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.57
|
| Rate for Payer: Multiplan Commercial |
$9.65
|
| Rate for Payer: Networks By Design Commercial |
$8.37
|
| Rate for Payer: Prime Health Services Commercial |
$10.94
|
|
|
HC SUTURE VICRYL 2-0 27" CT-1
|
Facility
OP
|
$12.22
|
|
| Hospital Charge Code |
901602882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$11.00 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.42
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.22
|
| Rate for Payer: BCBS Transplant Transplant |
$7.33
|
| Rate for Payer: Blue Shield of California Commercial |
$7.69
|
| Rate for Payer: Blue Shield of California EPN |
$5.98
|
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Central Health Plan Commercial |
$9.78
|
| Rate for Payer: Cigna of CA HMO |
$7.82
|
| Rate for Payer: Cigna of CA PPO |
$9.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.89
|
| Rate for Payer: Galaxy Health WC |
$10.39
|
| Rate for Payer: Global Benefits Group Commercial |
$7.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.16
|
| Rate for Payer: IEHP medi-cal |
$4.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.44
|
| Rate for Payer: Multiplan Commercial |
$9.16
|
| Rate for Payer: Networks By Design Commercial |
$7.94
|
| Rate for Payer: Prime Health Services Commercial |
$10.39
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.33
|
| Rate for Payer: Riverside University Health MISP |
$4.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.11
|
| Rate for Payer: United Healthcare All Other HMO |
$6.11
|
| Rate for Payer: United Healthcare HMO Rider |
$6.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.39
|
| Rate for Payer: Vantage Medical Group Senior |
$10.39
|
|
|
HC SUTURE VICRYL 2-0 27" CT-1
|
Facility
IP
|
$12.22
|
|
| Hospital Charge Code |
901602882
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.44 |
| Max. Negotiated Rate |
$11.00 |
| Rate for Payer: Cash Price |
$5.50
|
| Rate for Payer: Central Health Plan Commercial |
$9.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.89
|
| Rate for Payer: Galaxy Health WC |
$10.39
|
| Rate for Payer: Global Benefits Group Commercial |
$7.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.44
|
| Rate for Payer: Multiplan Commercial |
$9.16
|
| Rate for Payer: Networks By Design Commercial |
$7.94
|
| Rate for Payer: Prime Health Services Commercial |
$10.39
|
|
|
HC SUTURE VICRYL 2-0 CT-1 210433
|
Facility
IP
|
$19.11
|
|
| Hospital Charge Code |
901693110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$17.20 |
| Rate for Payer: Cash Price |
$8.60
|
| Rate for Payer: Central Health Plan Commercial |
$15.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.64
|
| Rate for Payer: Galaxy Health WC |
$16.24
|
| Rate for Payer: Global Benefits Group Commercial |
$11.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.82
|
| Rate for Payer: Multiplan Commercial |
$14.33
|
| Rate for Payer: Networks By Design Commercial |
$12.42
|
| Rate for Payer: Prime Health Services Commercial |
$16.24
|
|
|
HC SUTURE VICRYL 2-0 CT-1 210433
|
Facility
OP
|
$19.11
|
|
| Hospital Charge Code |
901693110
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$17.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$11.61
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.29
|
| Rate for Payer: BCBS Transplant Transplant |
$11.47
|
| Rate for Payer: Blue Shield of California Commercial |
$12.02
|
| Rate for Payer: Blue Shield of California EPN |
$9.34
|
| Rate for Payer: Cash Price |
$8.60
|
| Rate for Payer: Central Health Plan Commercial |
$15.29
|
| Rate for Payer: Cigna of CA HMO |
$12.23
|
| Rate for Payer: Cigna of CA PPO |
$14.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.64
|
| Rate for Payer: Galaxy Health WC |
$16.24
|
| Rate for Payer: Global Benefits Group Commercial |
$11.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$14.33
|
| Rate for Payer: IEHP medi-cal |
$6.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.82
|
| Rate for Payer: Multiplan Commercial |
$14.33
|
| Rate for Payer: Networks By Design Commercial |
$12.42
|
| Rate for Payer: Prime Health Services Commercial |
$16.24
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$11.47
|
| Rate for Payer: Riverside University Health MISP |
$7.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.56
|
| Rate for Payer: United Healthcare All Other HMO |
$9.56
|
| Rate for Payer: United Healthcare HMO Rider |
$9.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.24
|
| Rate for Payer: Vantage Medical Group Senior |
$16.24
|
|
