|
HC SUTR/STPL RMVL REQUIRING ANES
|
Facility
|
OP
|
$7,970.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
907201033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$72.36 |
| Max. Negotiated Rate |
$7,378.00 |
| Rate for Payer: Adventist Health Commercial |
$1,594.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$2,324.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2,901.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,324.22
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3,974.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,311.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$3,703.23
|
| Rate for Payer: Blue Shield of California Commercial |
$3,172.31
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Cash Price |
$4,383.50
|
| Rate for Payer: Cash Price |
$4,383.50
|
| Rate for Payer: Cash Price |
$4,383.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,376.00
|
| Rate for Payer: Cigna of CA HMO |
$5,100.80
|
| Rate for Payer: Cigna of CA PPO |
$5,897.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2,324.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,137.70
|
| Rate for Payer: EPIC Health Plan Senior |
$2,324.22
|
| Rate for Payer: Galaxy Health WC |
$6,774.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,782.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,173.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,811.72
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$72.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.22
|
| Rate for Payer: InnovAge PACE Commercial |
$3,486.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,315.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,324.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,594.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3,114.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,114.45
|
| Rate for Payer: Multiplan Commercial |
$5,977.50
|
| Rate for Payer: Multiplan WC |
$3,703.23
|
| Rate for Payer: Networks By Design Commercial |
$5,180.50
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2,324.22
|
| Rate for Payer: Preferred Health Network WC |
$3,778.81
|
| Rate for Payer: Prime Health Services Commercial |
$6,774.50
|
| Rate for Payer: Prime Health Services Medicare |
$2,463.67
|
| Rate for Payer: Prime Health Services WC |
$3,665.45
|
| Rate for Payer: Riverside University Health System MISP |
$2,556.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4,782.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$6,208.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,378.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4,428.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4,122.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2,324.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.22
|
|
|
HC SUTR/STPL RMVL REQUIRING ANES
|
Facility
|
IP
|
$7,970.00
|
|
|
Service Code
|
CPT 15851
|
| Hospital Charge Code |
907201033
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,594.00 |
| Max. Negotiated Rate |
$7,173.00 |
| Rate for Payer: Adventist Health Commercial |
$1,594.00
|
| Rate for Payer: Cash Price |
$4,383.50
|
| Rate for Payer: Central Health Plan Commercial |
$6,376.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,188.00
|
| Rate for Payer: EPIC Health Plan Senior |
$3,188.00
|
| Rate for Payer: Galaxy Health WC |
$6,774.50
|
| Rate for Payer: Global Benefits Group Commercial |
$4,782.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$7,173.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5,315.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,036.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4,933.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,594.00
|
| Rate for Payer: Multiplan Commercial |
$5,977.50
|
| Rate for Payer: Networks By Design Commercial |
$5,180.50
|
| Rate for Payer: Prime Health Services Commercial |
$6,774.50
|
|
|
HC SUTR SURGISEAL TWIST PEN
|
Facility
|
OP
|
$110.00
|
|
| Hospital Charge Code |
906812537
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$66.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$93.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$82.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$53.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$64.60
|
| Rate for Payer: Blue Shield of California Commercial |
$67.21
|
| Rate for Payer: Blue Shield of California EPN |
$43.89
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Central Health Plan Commercial |
$88.00
|
| Rate for Payer: Cigna of CA HMO |
$70.40
|
| Rate for Payer: Cigna of CA PPO |
$81.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$93.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$93.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$93.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.00
|
| Rate for Payer: EPIC Health Plan Senior |
$44.00
|
| Rate for Payer: Galaxy Health WC |
$93.50
|
| Rate for Payer: Global Benefits Group Commercial |
$66.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.00
|
| Rate for Payer: InnovAge PACE Commercial |
$55.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$77.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$77.00
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
| Rate for Payer: Networks By Design Commercial |
$71.50
|
| Rate for Payer: Prime Health Services Commercial |
$93.50
|
| Rate for Payer: Riverside University Health System MISP |
$44.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$66.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$66.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$55.00
|
| Rate for Payer: United Healthcare All Other HMO |
$55.00
|
| Rate for Payer: United Healthcare HMO Rider |
$55.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$55.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$93.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$93.50
|
| Rate for Payer: Vantage Medical Group Senior |
$93.50
|
|
|
HC SUTR SURGISEAL TWIST PEN
|
Facility
|
IP
|
$110.00
|
|
| Hospital Charge Code |
906812537
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$22.00 |
| Max. Negotiated Rate |
$99.00 |
| Rate for Payer: Adventist Health Commercial |
$22.00
|
| Rate for Payer: Cash Price |
$60.50
|
| Rate for Payer: Central Health Plan Commercial |
$88.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$44.00
|
| Rate for Payer: EPIC Health Plan Senior |
$44.00
|
| Rate for Payer: Galaxy Health WC |
$93.50
|
| Rate for Payer: Global Benefits Group Commercial |
$66.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$99.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$73.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.91
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$68.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.00
|
| Rate for Payer: Multiplan Commercial |
$82.50
|
| Rate for Payer: Networks By Design Commercial |
$71.50
|
| Rate for Payer: Prime Health Services Commercial |
$93.50
|
|
|
HC SUTR VICRYL 5-0 PS-2 18" UNDYE
|
Facility
|
IP
|
$42.72
|
|
| Hospital Charge Code |
901698138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$38.45 |
| Rate for Payer: Adventist Health Commercial |
$8.54
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Central Health Plan Commercial |
$34.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.09
|
| Rate for Payer: EPIC Health Plan Senior |
$17.09
|
| Rate for Payer: Galaxy Health WC |
$36.31
|
| Rate for Payer: Global Benefits Group Commercial |
$25.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.54
|
| Rate for Payer: Multiplan Commercial |
$32.04
|
| Rate for Payer: Networks By Design Commercial |
$27.77
|
| Rate for Payer: Prime Health Services Commercial |
$36.31
|
|
|
HC SUTR VICRYL 5-0 PS-2 18" UNDYE
|
Facility
|
OP
|
$42.72
|
|
| Hospital Charge Code |
901698138
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$8.54 |
| Max. Negotiated Rate |
$38.45 |
| Rate for Payer: Adventist Health Commercial |
$8.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$36.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$23.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$20.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25.09
|
| Rate for Payer: Blue Shield of California Commercial |
$26.10
|
| Rate for Payer: Blue Shield of California EPN |
$17.05
|
| Rate for Payer: Cash Price |
$23.50
|
| Rate for Payer: Central Health Plan Commercial |
$34.18
|
| Rate for Payer: Cigna of CA HMO |
$27.34
|
| Rate for Payer: Cigna of CA PPO |
$31.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$36.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$36.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$36.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.09
|
| Rate for Payer: EPIC Health Plan Senior |
$17.09
|
| Rate for Payer: Galaxy Health WC |
$36.31
|
| Rate for Payer: Global Benefits Group Commercial |
$25.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$38.45
|
| Rate for Payer: InnovAge PACE Commercial |
$21.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$28.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$29.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$29.90
|
| Rate for Payer: Multiplan Commercial |
$32.04
|
| Rate for Payer: Networks By Design Commercial |
$27.77
|
| Rate for Payer: Prime Health Services Commercial |
$36.31
|
| Rate for Payer: Riverside University Health System MISP |
$17.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$25.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$25.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.36
|
| Rate for Payer: United Healthcare All Other HMO |
$21.36
|
| Rate for Payer: United Healthcare HMO Rider |
$21.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$21.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$36.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$36.31
|
| Rate for Payer: Vantage Medical Group Senior |
$36.31
|
|
|
HC SUTURE BONE WAX 2.5G
|
Facility
|
OP
|
$50.35
|
|
| Hospital Charge Code |
901604011
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.07 |
| Max. Negotiated Rate |
$45.31 |
| Rate for Payer: Adventist Health Commercial |
$10.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$30.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.57
|
| Rate for Payer: Blue Shield of California Commercial |
$30.76
|
| Rate for Payer: Blue Shield of California EPN |
$20.09
|
| Rate for Payer: Cash Price |
$27.69
|
| Rate for Payer: Central Health Plan Commercial |
$40.28
|
| Rate for Payer: Cigna of CA HMO |
$32.22
|
| Rate for Payer: Cigna of CA PPO |
$37.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.80
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.14
|
| Rate for Payer: EPIC Health Plan Senior |
$20.14
|
| Rate for Payer: Galaxy Health WC |
$42.80
|
| Rate for Payer: Global Benefits Group Commercial |
$30.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.31
|
| Rate for Payer: InnovAge PACE Commercial |
$25.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.24
|
| Rate for Payer: Multiplan Commercial |
$37.76
|
| Rate for Payer: Networks By Design Commercial |
$32.73
|
| Rate for Payer: Prime Health Services Commercial |
$42.80
|
| Rate for Payer: Riverside University Health System MISP |
$20.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.18
|
| Rate for Payer: United Healthcare All Other HMO |
$25.18
|
| Rate for Payer: United Healthcare HMO Rider |
$25.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.80
|
| Rate for Payer: Vantage Medical Group Senior |
$42.80
|
|
|
HC SUTURE BONE WAX 2.5G
|
Facility
|
IP
|
$50.35
|
|
| Hospital Charge Code |
901604011
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.07 |
| Max. Negotiated Rate |
$45.31 |
| Rate for Payer: Adventist Health Commercial |
$10.07
|
| Rate for Payer: Cash Price |
$27.69
|
| Rate for Payer: Central Health Plan Commercial |
$40.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.14
|
| Rate for Payer: EPIC Health Plan Senior |
$20.14
|
| Rate for Payer: Galaxy Health WC |
$42.80
|
| Rate for Payer: Global Benefits Group Commercial |
$30.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$31.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.07
|
| Rate for Payer: Multiplan Commercial |
$37.76
|
| Rate for Payer: Networks By Design Commercial |
$32.73
|
| Rate for Payer: Prime Health Services Commercial |
$42.80
|
|
|
HC SUTURE CHROMIC 0 CT-1 105252
|
Facility
|
IP
|
$27.55
|
|
| Hospital Charge Code |
901694630
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$24.80 |
| Rate for Payer: Adventist Health Commercial |
$5.51
|
| Rate for Payer: Cash Price |
$15.15
|
| Rate for Payer: Central Health Plan Commercial |
$22.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.02
|
| Rate for Payer: EPIC Health Plan Senior |
$11.02
|
| Rate for Payer: Galaxy Health WC |
$23.42
|
| Rate for Payer: Global Benefits Group Commercial |
$16.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.51
|
| Rate for Payer: Multiplan Commercial |
$20.66
|
| Rate for Payer: Networks By Design Commercial |
$17.91
|
| Rate for Payer: Prime Health Services Commercial |
$23.42
|
|
|
HC SUTURE CHROMIC 0 CT-1 105252
|
Facility
|
OP
|
$27.55
|
|
| Hospital Charge Code |
901694630
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.51 |
| Max. Negotiated Rate |
$24.80 |
| Rate for Payer: Adventist Health Commercial |
$5.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.42
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.18
|
| Rate for Payer: Blue Shield of California Commercial |
$16.83
|
| Rate for Payer: Blue Shield of California EPN |
$10.99
|
| Rate for Payer: Cash Price |
$15.15
|
| Rate for Payer: Central Health Plan Commercial |
$22.04
|
| Rate for Payer: Cigna of CA HMO |
$17.63
|
| Rate for Payer: Cigna of CA PPO |
$20.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.02
|
| Rate for Payer: EPIC Health Plan Senior |
$11.02
|
| Rate for Payer: Galaxy Health WC |
$23.42
|
| Rate for Payer: Global Benefits Group Commercial |
$16.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.80
|
| Rate for Payer: InnovAge PACE Commercial |
$13.78
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.29
|
| Rate for Payer: Multiplan Commercial |
$20.66
|
| Rate for Payer: Networks By Design Commercial |
$17.91
|
| Rate for Payer: Prime Health Services Commercial |
$23.42
|
| Rate for Payer: Riverside University Health System MISP |
$11.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.78
|
| Rate for Payer: United Healthcare All Other HMO |
$13.78
|
| Rate for Payer: United Healthcare HMO Rider |
$13.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.42
|
| Rate for Payer: Vantage Medical Group Senior |
$23.42
|
|
|
HC SUTURE CHROMIC 0 CT-2 104499
|
Facility
|
IP
|
$31.65
|
|
| Hospital Charge Code |
901694858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$28.48 |
| Rate for Payer: Adventist Health Commercial |
$6.33
|
| Rate for Payer: Cash Price |
$17.41
|
| Rate for Payer: Central Health Plan Commercial |
$25.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12.66
|
| Rate for Payer: Galaxy Health WC |
$26.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.33
|
| Rate for Payer: Multiplan Commercial |
$23.74
|
| Rate for Payer: Networks By Design Commercial |
$20.57
|
| Rate for Payer: Prime Health Services Commercial |
$26.90
|
|
|
HC SUTURE CHROMIC 0 CT-2 104499
|
Facility
|
OP
|
$31.65
|
|
| Hospital Charge Code |
901694858
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.33 |
| Max. Negotiated Rate |
$28.48 |
| Rate for Payer: Adventist Health Commercial |
$6.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$19.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.59
|
| Rate for Payer: Blue Shield of California Commercial |
$19.34
|
| Rate for Payer: Blue Shield of California EPN |
$12.63
|
| Rate for Payer: Cash Price |
$17.41
|
| Rate for Payer: Central Health Plan Commercial |
$25.32
|
| Rate for Payer: Cigna of CA HMO |
$20.26
|
| Rate for Payer: Cigna of CA PPO |
$23.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.66
|
| Rate for Payer: EPIC Health Plan Senior |
$12.66
|
| Rate for Payer: Galaxy Health WC |
$26.90
|
| Rate for Payer: Global Benefits Group Commercial |
$18.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.48
|
| Rate for Payer: InnovAge PACE Commercial |
$15.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$22.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.16
|
| Rate for Payer: Multiplan Commercial |
$23.74
|
| Rate for Payer: Networks By Design Commercial |
$20.57
|
| Rate for Payer: Prime Health Services Commercial |
$26.90
|
| Rate for Payer: Riverside University Health System MISP |
$12.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.82
|
| Rate for Payer: United Healthcare All Other HMO |
$15.82
|
| Rate for Payer: United Healthcare HMO Rider |
$15.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.90
|
| Rate for Payer: Vantage Medical Group Senior |
$26.90
|
|
|
HC SUTURE CHROMIC 0 SH 178211
|
Facility
|
IP
|
$21.16
|
|
| Hospital Charge Code |
901694861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$19.04 |
| Rate for Payer: Adventist Health Commercial |
$4.23
|
| Rate for Payer: Cash Price |
$11.64
|
| Rate for Payer: Central Health Plan Commercial |
$16.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.46
|
| Rate for Payer: EPIC Health Plan Senior |
$8.46
|
| Rate for Payer: Galaxy Health WC |
$17.99
|
| Rate for Payer: Global Benefits Group Commercial |
$12.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.23
|
| Rate for Payer: Multiplan Commercial |
$15.87
|
| Rate for Payer: Networks By Design Commercial |
$13.75
|
| Rate for Payer: Prime Health Services Commercial |
$17.99
|
|
|
HC SUTURE CHROMIC 0 SH 178211
|
Facility
|
OP
|
$21.16
|
|
| Hospital Charge Code |
901694861
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.23 |
| Max. Negotiated Rate |
$19.04 |
| Rate for Payer: Adventist Health Commercial |
$4.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$17.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.43
|
| Rate for Payer: Blue Shield of California Commercial |
$12.93
|
| Rate for Payer: Blue Shield of California EPN |
$8.44
|
| Rate for Payer: Cash Price |
$11.64
|
| Rate for Payer: Central Health Plan Commercial |
$16.93
|
| Rate for Payer: Cigna of CA HMO |
$13.54
|
| Rate for Payer: Cigna of CA PPO |
$15.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.99
|
| Rate for Payer: Dignity Health Medicare Advantage |
$17.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.46
|
| Rate for Payer: EPIC Health Plan Senior |
$8.46
|
| Rate for Payer: Galaxy Health WC |
$17.99
|
| Rate for Payer: Global Benefits Group Commercial |
$12.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.04
|
| Rate for Payer: InnovAge PACE Commercial |
$10.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.81
|
| Rate for Payer: Multiplan Commercial |
$15.87
|
| Rate for Payer: Networks By Design Commercial |
$13.75
|
| Rate for Payer: Prime Health Services Commercial |
$17.99
|
| Rate for Payer: Riverside University Health System MISP |
$8.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.58
|
| Rate for Payer: United Healthcare All Other HMO |
$10.58
|
| Rate for Payer: United Healthcare HMO Rider |
$10.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.99
|
| Rate for Payer: Vantage Medical Group Senior |
$17.99
|
|
|
HC SUTURE CHROMIC 1-0 27" 100173
|
Facility
|
OP
|
$28.62
|
|
| Hospital Charge Code |
901694628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$25.76 |
| Rate for Payer: Adventist Health Commercial |
$5.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.81
|
| Rate for Payer: Blue Shield of California Commercial |
$17.49
|
| Rate for Payer: Blue Shield of California EPN |
$11.42
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Central Health Plan Commercial |
$22.90
|
| Rate for Payer: Cigna of CA HMO |
$18.32
|
| Rate for Payer: Cigna of CA PPO |
$21.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.45
|
| Rate for Payer: EPIC Health Plan Senior |
$11.45
|
| Rate for Payer: Galaxy Health WC |
$24.33
|
| Rate for Payer: Global Benefits Group Commercial |
$17.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.76
|
| Rate for Payer: InnovAge PACE Commercial |
$14.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.03
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.03
|
| Rate for Payer: Multiplan Commercial |
$21.46
|
| Rate for Payer: Networks By Design Commercial |
$18.60
|
| Rate for Payer: Prime Health Services Commercial |
$24.33
|
| Rate for Payer: Riverside University Health System MISP |
$11.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.31
|
| Rate for Payer: United Healthcare All Other HMO |
$14.31
|
| Rate for Payer: United Healthcare HMO Rider |
$14.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.33
|
| Rate for Payer: Vantage Medical Group Senior |
$24.33
|
|
|
HC SUTURE CHROMIC 1-0 27" 100173
|
Facility
|
IP
|
$28.62
|
|
| Hospital Charge Code |
901694628
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.72 |
| Max. Negotiated Rate |
$25.76 |
| Rate for Payer: Adventist Health Commercial |
$5.72
|
| Rate for Payer: Cash Price |
$15.74
|
| Rate for Payer: Central Health Plan Commercial |
$22.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.45
|
| Rate for Payer: EPIC Health Plan Senior |
$11.45
|
| Rate for Payer: Galaxy Health WC |
$24.33
|
| Rate for Payer: Global Benefits Group Commercial |
$17.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.90
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.72
|
| Rate for Payer: Multiplan Commercial |
$21.46
|
| Rate for Payer: Networks By Design Commercial |
$18.60
|
| Rate for Payer: Prime Health Services Commercial |
$24.33
|
|
|
HC SUTURE CHROMIC 1-0 54" REEL
|
Facility
|
IP
|
$28.04
|
|
| Hospital Charge Code |
901694866
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$25.24 |
| Rate for Payer: Adventist Health Commercial |
$5.61
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Central Health Plan Commercial |
$22.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.22
|
| Rate for Payer: EPIC Health Plan Senior |
$11.22
|
| Rate for Payer: Galaxy Health WC |
$23.83
|
| Rate for Payer: Global Benefits Group Commercial |
$16.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.61
|
| Rate for Payer: Multiplan Commercial |
$21.03
|
| Rate for Payer: Networks By Design Commercial |
$18.23
|
| Rate for Payer: Prime Health Services Commercial |
$23.83
|
|
|
HC SUTURE CHROMIC 1-0 54" REEL
|
Facility
|
OP
|
$28.04
|
|
| Hospital Charge Code |
901694866
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$25.24 |
| Rate for Payer: Adventist Health Commercial |
$5.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.47
|
| Rate for Payer: Blue Shield of California Commercial |
$17.13
|
| Rate for Payer: Blue Shield of California EPN |
$11.19
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Central Health Plan Commercial |
$22.43
|
| Rate for Payer: Cigna of CA HMO |
$17.95
|
| Rate for Payer: Cigna of CA PPO |
$20.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.22
|
| Rate for Payer: EPIC Health Plan Senior |
$11.22
|
| Rate for Payer: Galaxy Health WC |
$23.83
|
| Rate for Payer: Global Benefits Group Commercial |
$16.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.24
|
| Rate for Payer: InnovAge PACE Commercial |
$14.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.63
|
| Rate for Payer: Multiplan Commercial |
$21.03
|
| Rate for Payer: Networks By Design Commercial |
$18.23
|
| Rate for Payer: Prime Health Services Commercial |
$23.83
|
| Rate for Payer: Riverside University Health System MISP |
$11.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.02
|
| Rate for Payer: United Healthcare All Other HMO |
$14.02
|
| Rate for Payer: United Healthcare HMO Rider |
$14.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.83
|
| Rate for Payer: Vantage Medical Group Senior |
$23.83
|
|
|
HC SUTURE CHROMIC 1-0 CT1 102836
|
Facility
|
OP
|
$34.85
|
|
| Hospital Charge Code |
901694862
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.97 |
| Max. Negotiated Rate |
$31.36 |
| Rate for Payer: Adventist Health Commercial |
$6.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.47
|
| Rate for Payer: Blue Shield of California Commercial |
$21.29
|
| Rate for Payer: Blue Shield of California EPN |
$13.91
|
| Rate for Payer: Cash Price |
$19.17
|
| Rate for Payer: Central Health Plan Commercial |
$27.88
|
| Rate for Payer: Cigna of CA HMO |
$22.30
|
| Rate for Payer: Cigna of CA PPO |
$25.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.94
|
| Rate for Payer: EPIC Health Plan Senior |
$13.94
|
| Rate for Payer: Galaxy Health WC |
$29.62
|
| Rate for Payer: Global Benefits Group Commercial |
$20.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.36
|
| Rate for Payer: InnovAge PACE Commercial |
$17.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.39
|
| Rate for Payer: Multiplan Commercial |
$26.14
|
| Rate for Payer: Networks By Design Commercial |
$22.65
|
| Rate for Payer: Prime Health Services Commercial |
$29.62
|
| Rate for Payer: Riverside University Health System MISP |
$13.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$17.43
|
| Rate for Payer: United Healthcare All Other HMO |
$17.43
|
| Rate for Payer: United Healthcare HMO Rider |
$17.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.62
|
| Rate for Payer: Vantage Medical Group Senior |
$29.62
|
|
|
HC SUTURE CHROMIC 1-0 CT1 102836
|
Facility
|
IP
|
$34.85
|
|
| Hospital Charge Code |
901694862
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.97 |
| Max. Negotiated Rate |
$31.36 |
| Rate for Payer: Adventist Health Commercial |
$6.97
|
| Rate for Payer: Cash Price |
$19.17
|
| Rate for Payer: Central Health Plan Commercial |
$27.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.94
|
| Rate for Payer: EPIC Health Plan Senior |
$13.94
|
| Rate for Payer: Galaxy Health WC |
$29.62
|
| Rate for Payer: Global Benefits Group Commercial |
$20.91
|
| Rate for Payer: Health Management Network EPO/PPO |
$31.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.97
|
| Rate for Payer: Multiplan Commercial |
$26.14
|
| Rate for Payer: Networks By Design Commercial |
$22.65
|
| Rate for Payer: Prime Health Services Commercial |
$29.62
|
|
|
HC SUTURE CHROMIC 2-0 100127
|
Facility
|
OP
|
$31.16
|
|
| Hospital Charge Code |
901694653
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$28.04 |
| Rate for Payer: Adventist Health Commercial |
$6.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.92
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$26.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$23.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.30
|
| Rate for Payer: Blue Shield of California Commercial |
$19.04
|
| Rate for Payer: Blue Shield of California EPN |
$12.43
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Central Health Plan Commercial |
$24.93
|
| Rate for Payer: Cigna of CA HMO |
$19.94
|
| Rate for Payer: Cigna of CA PPO |
$23.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$26.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$26.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.46
|
| Rate for Payer: EPIC Health Plan Senior |
$12.46
|
| Rate for Payer: Galaxy Health WC |
$26.49
|
| Rate for Payer: Global Benefits Group Commercial |
$18.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.04
|
| Rate for Payer: InnovAge PACE Commercial |
$15.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.81
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.81
|
| Rate for Payer: Multiplan Commercial |
$23.37
|
| Rate for Payer: Networks By Design Commercial |
$20.25
|
| Rate for Payer: Prime Health Services Commercial |
$26.49
|
| Rate for Payer: Riverside University Health System MISP |
$12.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.58
|
| Rate for Payer: United Healthcare All Other HMO |
$15.58
|
| Rate for Payer: United Healthcare HMO Rider |
$15.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$26.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.49
|
| Rate for Payer: Vantage Medical Group Senior |
$26.49
|
|
|
HC SUTURE CHROMIC 2-0 100127
|
Facility
|
IP
|
$31.16
|
|
| Hospital Charge Code |
901694653
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.23 |
| Max. Negotiated Rate |
$28.04 |
| Rate for Payer: Adventist Health Commercial |
$6.23
|
| Rate for Payer: Cash Price |
$17.14
|
| Rate for Payer: Central Health Plan Commercial |
$24.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.46
|
| Rate for Payer: EPIC Health Plan Senior |
$12.46
|
| Rate for Payer: Galaxy Health WC |
$26.49
|
| Rate for Payer: Global Benefits Group Commercial |
$18.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$19.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.23
|
| Rate for Payer: Multiplan Commercial |
$23.37
|
| Rate for Payer: Networks By Design Commercial |
$20.25
|
| Rate for Payer: Prime Health Services Commercial |
$26.49
|
|
|
HC SUTURE CHROMIC 2-0 100243
|
Facility
|
IP
|
$23.94
|
|
| Hospital Charge Code |
901694867
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$21.55 |
| Rate for Payer: Adventist Health Commercial |
$4.79
|
| Rate for Payer: Cash Price |
$13.17
|
| Rate for Payer: Central Health Plan Commercial |
$19.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.58
|
| Rate for Payer: EPIC Health Plan Senior |
$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: Kaiser Permanente of CA Medi-Cal |
$9.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.79
|
| Rate for Payer: Multiplan Commercial |
$17.95
|
| Rate for Payer: Networks By Design Commercial |
$15.56
|
| Rate for Payer: Prime Health Services Commercial |
$20.35
|
|
|
HC SUTURE CHROMIC 2-0 100243
|
Facility
|
OP
|
$23.94
|
|
| Hospital Charge Code |
901694867
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.79 |
| Max. Negotiated Rate |
$21.55 |
| Rate for Payer: Adventist Health Commercial |
$4.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.06
|
| Rate for Payer: Blue Shield of California Commercial |
$14.63
|
| Rate for Payer: Blue Shield of California EPN |
$9.55
|
| Rate for Payer: Cash Price |
$13.17
|
| 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: Dignity Health Medi-Cal |
$20.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.58
|
| Rate for Payer: EPIC Health Plan Senior |
$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: InnovAge PACE Commercial |
$11.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$14.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.76
|
| Rate for Payer: Multiplan Commercial |
$17.95
|
| Rate for Payer: Networks By Design Commercial |
$15.56
|
| Rate for Payer: Prime Health Services Commercial |
$20.35
|
| Rate for Payer: Riverside University Health System 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 Commercial/Exchange |
$20.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.35
|
| Rate for Payer: Vantage Medical Group Senior |
$20.35
|
|
|
HC SUTURE CHROMIC 2-0 27" CT-1
|
Facility
|
IP
|
$32.47
|
|
| Hospital Charge Code |
901602880
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.49 |
| Max. Negotiated Rate |
$29.22 |
| Rate for Payer: Adventist Health Commercial |
$6.49
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Central Health Plan Commercial |
$25.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.99
|
| Rate for Payer: EPIC Health Plan Senior |
$12.99
|
| Rate for Payer: Galaxy Health WC |
$27.60
|
| Rate for Payer: Global Benefits Group Commercial |
$19.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.49
|
| Rate for Payer: Multiplan Commercial |
$24.35
|
| Rate for Payer: Networks By Design Commercial |
$21.11
|
| Rate for Payer: Prime Health Services Commercial |
$27.60
|
|
