|
HC SUTURE VICRYL 2-0 TIES 12-18
|
Facility
OP
|
$50.02
|
|
| Hospital Charge Code |
901694623
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$45.02 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$42.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$24.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.55
|
| Rate for Payer: BCBS Transplant Transplant |
$30.01
|
| Rate for Payer: Blue Shield of California Commercial |
$31.46
|
| Rate for Payer: Blue Shield of California EPN |
$24.46
|
| Rate for Payer: Cash Price |
$22.51
|
| Rate for Payer: Central Health Plan Commercial |
$40.02
|
| Rate for Payer: Cigna of CA HMO |
$32.01
|
| Rate for Payer: Cigna of CA PPO |
$37.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.01
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.01
|
| Rate for Payer: Galaxy Health WC |
$42.52
|
| Rate for Payer: Global Benefits Group Commercial |
$30.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.02
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$37.52
|
| Rate for Payer: IEHP medi-cal |
$17.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Multiplan Commercial |
$37.52
|
| Rate for Payer: Networks By Design Commercial |
$32.51
|
| Rate for Payer: Prime Health Services Commercial |
$42.52
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$30.01
|
| Rate for Payer: Riverside University Health MISP |
$20.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.01
|
| Rate for Payer: United Healthcare All Other HMO |
$25.01
|
| Rate for Payer: United Healthcare HMO Rider |
$25.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.52
|
| Rate for Payer: Vantage Medical Group Senior |
$42.52
|
|
|
HC SUTURE VICRYL 2-0 TIES 12-18
|
Facility
IP
|
$50.02
|
|
| Hospital Charge Code |
901694623
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$10.00 |
| Max. Negotiated Rate |
$45.02 |
| Rate for Payer: Cash Price |
$22.51
|
| Rate for Payer: Central Health Plan Commercial |
$40.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.01
|
| Rate for Payer: Galaxy Health WC |
$42.52
|
| Rate for Payer: Global Benefits Group Commercial |
$30.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$45.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$33.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.00
|
| Rate for Payer: Multiplan Commercial |
$37.52
|
| Rate for Payer: Networks By Design Commercial |
$32.51
|
| Rate for Payer: Prime Health Services Commercial |
$42.52
|
|
|
HC SUTURE VICRYL 3-0 101329
|
Facility
OP
|
$14.35
|
|
| Hospital Charge Code |
901694876
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.87 |
| Max. Negotiated Rate |
$12.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.71
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.89
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.48
|
| Rate for Payer: BCBS Transplant Transplant |
$8.61
|
| Rate for Payer: Blue Shield of California Commercial |
$9.03
|
| Rate for Payer: Blue Shield of California EPN |
$7.02
|
| Rate for Payer: Cash Price |
$6.46
|
| Rate for Payer: Central Health Plan Commercial |
$11.48
|
| Rate for Payer: Cigna of CA HMO |
$9.18
|
| Rate for Payer: Cigna of CA PPO |
$10.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.74
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$12.20
|
| Rate for Payer: Global Benefits Group Commercial |
$8.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.92
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.76
|
| Rate for Payer: IEHP medi-cal |
$5.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.87
|
| Rate for Payer: Multiplan Commercial |
$10.76
|
| Rate for Payer: Networks By Design Commercial |
$9.33
|
| Rate for Payer: Prime Health Services Commercial |
$12.20
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.61
|
| Rate for Payer: Riverside University Health MISP |
$5.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.18
|
| Rate for Payer: United Healthcare All Other HMO |
$7.18
|
| Rate for Payer: United Healthcare HMO Rider |
$7.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.20
|
| Rate for Payer: Vantage Medical Group Senior |
$12.20
|
|
|
HC SUTURE VICRYL 3-0 101329
|
Facility
IP
|
$14.35
|
|
| Hospital Charge Code |
901694876
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.87 |
| Max. Negotiated Rate |
$12.92 |
| Rate for Payer: Cash Price |
$6.46
|
| Rate for Payer: Central Health Plan Commercial |
$11.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.74
|
| Rate for Payer: Galaxy Health WC |
$12.20
|
| Rate for Payer: Global Benefits Group Commercial |
$8.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.87
|
| Rate for Payer: Multiplan Commercial |
$10.76
|
| Rate for Payer: Networks By Design Commercial |
$9.33
|
| Rate for Payer: Prime Health Services Commercial |
$12.20
|
|
|
HC SUTURE VICRYL 3-0 18"
|
Facility
OP
|
$29.11
|
|
| Hospital Charge Code |
901604232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.82 |
| Max. Negotiated Rate |
$26.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.68
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.74
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.01
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.20
|
| Rate for Payer: BCBS Transplant Transplant |
$17.47
|
| Rate for Payer: Blue Shield of California Commercial |
$18.31
|
| Rate for Payer: Blue Shield of California EPN |
$14.23
|
| Rate for Payer: Cash Price |
$13.10
|
| Rate for Payer: Central Health Plan Commercial |
$23.29
|
| Rate for Payer: Cigna of CA HMO |
$18.63
|
| Rate for Payer: Cigna of CA PPO |
$21.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.64
|
| Rate for Payer: Galaxy Health WC |
$24.74
|
| Rate for Payer: Global Benefits Group Commercial |
$17.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21.83
|
| Rate for Payer: IEHP medi-cal |
$10.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.82
|
| Rate for Payer: Multiplan Commercial |
$21.83
|
| Rate for Payer: Networks By Design Commercial |
$18.92
|
| Rate for Payer: Prime Health Services Commercial |
$24.74
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.47
|
| Rate for Payer: Riverside University Health MISP |
$11.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.56
|
| Rate for Payer: United Healthcare All Other HMO |
$14.56
|
| Rate for Payer: United Healthcare HMO Rider |
$14.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.74
|
| Rate for Payer: Vantage Medical Group Senior |
$24.74
|
|
|
HC SUTURE VICRYL 3-0 18"
|
Facility
IP
|
$29.11
|
|
| Hospital Charge Code |
901604232
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.82 |
| Max. Negotiated Rate |
$26.20 |
| Rate for Payer: Cash Price |
$13.10
|
| Rate for Payer: Central Health Plan Commercial |
$23.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.64
|
| Rate for Payer: Galaxy Health WC |
$24.74
|
| Rate for Payer: Global Benefits Group Commercial |
$17.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.82
|
| Rate for Payer: Multiplan Commercial |
$21.83
|
| Rate for Payer: Networks By Design Commercial |
$18.92
|
| Rate for Payer: Prime Health Services Commercial |
$24.74
|
|
|
HC SUTURE VICRYL 3-0 18" UD BRD
|
Facility
OP
|
$33.95
|
|
| Hospital Charge Code |
901694946
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$30.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20.62
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$28.86
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$18.67
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$18.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$20.06
|
| Rate for Payer: BCBS Transplant Transplant |
$20.37
|
| Rate for Payer: Blue Shield of California Commercial |
$21.35
|
| Rate for Payer: Blue Shield of California EPN |
$16.60
|
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Central Health Plan Commercial |
$27.16
|
| Rate for Payer: Cigna of CA HMO |
$21.73
|
| Rate for Payer: Cigna of CA PPO |
$25.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.58
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.58
|
| Rate for Payer: Galaxy Health WC |
$28.86
|
| Rate for Payer: Global Benefits Group Commercial |
$20.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.56
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$25.46
|
| Rate for Payer: IEHP medi-cal |
$11.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.79
|
| Rate for Payer: Multiplan Commercial |
$25.46
|
| Rate for Payer: Networks By Design Commercial |
$22.07
|
| Rate for Payer: Prime Health Services Commercial |
$28.86
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$20.37
|
| Rate for Payer: Riverside University Health MISP |
$13.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.98
|
| Rate for Payer: United Healthcare All Other HMO |
$16.98
|
| Rate for Payer: United Healthcare HMO Rider |
$16.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.86
|
| Rate for Payer: Vantage Medical Group Senior |
$28.86
|
|
|
HC SUTURE VICRYL 3-0 18" UD BRD
|
Facility
IP
|
$33.95
|
|
| Hospital Charge Code |
901694946
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.79 |
| Max. Negotiated Rate |
$30.56 |
| Rate for Payer: Cash Price |
$15.28
|
| Rate for Payer: Central Health Plan Commercial |
$27.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.58
|
| Rate for Payer: Galaxy Health WC |
$28.86
|
| Rate for Payer: Global Benefits Group Commercial |
$20.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.79
|
| Rate for Payer: Multiplan Commercial |
$25.46
|
| Rate for Payer: Networks By Design Commercial |
$22.07
|
| Rate for Payer: Prime Health Services Commercial |
$28.86
|
|
|
HC SUTURE VICRYL 3-0 27" CT1
|
Facility
IP
|
$12.30
|
|
| Hospital Charge Code |
901602883
|
|
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 3-0 27" CT1
|
Facility
OP
|
$12.30
|
|
| Hospital Charge Code |
901602883
|
|
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 3-0 27" RB-1
|
Facility
IP
|
$13.37
|
|
| Hospital Charge Code |
901604408
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$12.03 |
| Rate for Payer: Cash Price |
$6.02
|
| Rate for Payer: Central Health Plan Commercial |
$10.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.35
|
| 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 |
$12.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.67
|
| Rate for Payer: Multiplan Commercial |
$10.03
|
| Rate for Payer: Networks By Design Commercial |
$8.69
|
| Rate for Payer: Prime Health Services Commercial |
$11.36
|
|
|
HC SUTURE VICRYL 3-0 27" RB-1
|
Facility
OP
|
$13.37
|
|
| Hospital Charge Code |
901604408
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.67 |
| Max. Negotiated Rate |
$12.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.12
|
| 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 |
$7.90
|
| Rate for Payer: BCBS Transplant Transplant |
$8.02
|
| Rate for Payer: Blue Shield of California Commercial |
$8.41
|
| Rate for Payer: Blue Shield of California EPN |
$6.54
|
| Rate for Payer: Cash Price |
$6.02
|
| Rate for Payer: Central Health Plan Commercial |
$10.70
|
| Rate for Payer: Cigna of CA HMO |
$8.56
|
| 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 |
$5.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.35
|
| 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 |
$12.03
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.03
|
| Rate for Payer: IEHP medi-cal |
$4.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.67
|
| Rate for Payer: Multiplan Commercial |
$10.03
|
| Rate for Payer: Networks By Design Commercial |
$8.69
|
| 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 |
$5.35
|
| 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 3-0 27" SH
|
Facility
IP
|
$11.89
|
|
| Hospital Charge Code |
901604300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$10.70 |
| Rate for Payer: Cash Price |
$5.35
|
| Rate for Payer: Central Health Plan Commercial |
$9.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.76
|
| Rate for Payer: Galaxy Health WC |
$10.11
|
| Rate for Payer: Global Benefits Group Commercial |
$7.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: Multiplan Commercial |
$8.92
|
| Rate for Payer: Networks By Design Commercial |
$7.73
|
| Rate for Payer: Prime Health Services Commercial |
$10.11
|
|
|
HC SUTURE VICRYL 3-0 27" SH
|
Facility
OP
|
$11.89
|
|
| Hospital Charge Code |
901604300
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$10.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.54
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.02
|
| Rate for Payer: BCBS Transplant Transplant |
$7.13
|
| Rate for Payer: Blue Shield of California Commercial |
$7.48
|
| Rate for Payer: Blue Shield of California EPN |
$5.81
|
| Rate for Payer: Cash Price |
$5.35
|
| Rate for Payer: Central Health Plan Commercial |
$9.51
|
| Rate for Payer: Cigna of CA HMO |
$7.61
|
| Rate for Payer: Cigna of CA PPO |
$8.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.76
|
| Rate for Payer: Galaxy Health WC |
$10.11
|
| Rate for Payer: Global Benefits Group Commercial |
$7.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.92
|
| Rate for Payer: IEHP medi-cal |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: Multiplan Commercial |
$8.92
|
| Rate for Payer: Networks By Design Commercial |
$7.73
|
| Rate for Payer: Prime Health Services Commercial |
$10.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.13
|
| Rate for Payer: Riverside University Health MISP |
$4.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.94
|
| Rate for Payer: United Healthcare All Other HMO |
$5.94
|
| Rate for Payer: United Healthcare HMO Rider |
$5.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.11
|
| Rate for Payer: Vantage Medical Group Senior |
$10.11
|
|
|
HC SUTURE VICRYL 3-0 REEL 101330
|
Facility
IP
|
$13.45
|
|
| Hospital Charge Code |
901694875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$12.10 |
| Rate for Payer: Cash Price |
$6.05
|
| Rate for Payer: Central Health Plan Commercial |
$10.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.38
|
| Rate for Payer: Galaxy Health WC |
$11.43
|
| Rate for Payer: Global Benefits Group Commercial |
$8.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$10.09
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
|
|
HC SUTURE VICRYL 3-0 REEL 101330
|
Facility
OP
|
$13.45
|
|
| Hospital Charge Code |
901694875
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.69 |
| Max. Negotiated Rate |
$12.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.43
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.95
|
| Rate for Payer: BCBS Transplant Transplant |
$8.07
|
| Rate for Payer: Blue Shield of California Commercial |
$8.46
|
| Rate for Payer: Blue Shield of California EPN |
$6.58
|
| Rate for Payer: Cash Price |
$6.05
|
| Rate for Payer: Central Health Plan Commercial |
$10.76
|
| Rate for Payer: Cigna of CA HMO |
$8.61
|
| Rate for Payer: Cigna of CA PPO |
$9.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.38
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.38
|
| Rate for Payer: Galaxy Health WC |
$11.43
|
| Rate for Payer: Global Benefits Group Commercial |
$8.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.09
|
| Rate for Payer: IEHP medi-cal |
$4.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$10.09
|
| Rate for Payer: Networks By Design Commercial |
$8.74
|
| Rate for Payer: Prime Health Services Commercial |
$11.43
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.07
|
| Rate for Payer: Riverside University Health MISP |
$5.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.72
|
| Rate for Payer: United Healthcare All Other HMO |
$6.72
|
| Rate for Payer: United Healthcare HMO Rider |
$6.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.43
|
| Rate for Payer: Vantage Medical Group Senior |
$11.43
|
|
|
HC SUTURE VICRYL 4-0 18" PS-2
|
Facility
OP
|
$28.37
|
|
| Hospital Charge Code |
901604233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$25.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.11
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.76
|
| Rate for Payer: BCBS Transplant Transplant |
$17.02
|
| Rate for Payer: Blue Shield of California Commercial |
$17.84
|
| Rate for Payer: Blue Shield of California EPN |
$13.87
|
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Central Health Plan Commercial |
$22.70
|
| Rate for Payer: Cigna of CA HMO |
$18.16
|
| Rate for Payer: Cigna of CA PPO |
$20.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.35
|
| Rate for Payer: Galaxy Health WC |
$24.11
|
| Rate for Payer: Global Benefits Group Commercial |
$17.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.53
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21.28
|
| Rate for Payer: IEHP medi-cal |
$9.93
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.67
|
| Rate for Payer: Multiplan Commercial |
$21.28
|
| Rate for Payer: Networks By Design Commercial |
$18.44
|
| Rate for Payer: Prime Health Services Commercial |
$24.11
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.02
|
| Rate for Payer: Riverside University Health MISP |
$11.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.18
|
| Rate for Payer: United Healthcare All Other HMO |
$14.18
|
| Rate for Payer: United Healthcare HMO Rider |
$14.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.11
|
| Rate for Payer: Vantage Medical Group Senior |
$24.11
|
|
|
HC SUTURE VICRYL 4-0 18" PS-2
|
Facility
IP
|
$28.37
|
|
| Hospital Charge Code |
901604233
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.67 |
| Max. Negotiated Rate |
$25.53 |
| Rate for Payer: Cash Price |
$12.77
|
| Rate for Payer: Central Health Plan Commercial |
$22.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.35
|
| Rate for Payer: Galaxy Health WC |
$24.11
|
| Rate for Payer: Global Benefits Group Commercial |
$17.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.67
|
| Rate for Payer: Multiplan Commercial |
$21.28
|
| Rate for Payer: Networks By Design Commercial |
$18.44
|
| Rate for Payer: Prime Health Services Commercial |
$24.11
|
|
|
HC SUTURE VICRYL 4-0 27" 109330
|
Facility
OP
|
$16.40
|
|
| Hospital Charge Code |
901694879
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$14.76 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9.96
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.94
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.94
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.69
|
| Rate for Payer: BCBS Transplant Transplant |
$9.84
|
| Rate for Payer: Blue Shield of California Commercial |
$10.32
|
| Rate for Payer: Blue Shield of California EPN |
$8.02
|
| Rate for Payer: Cash Price |
$7.38
|
| Rate for Payer: Central Health Plan Commercial |
$13.12
|
| Rate for Payer: Cigna of CA HMO |
$10.50
|
| Rate for Payer: Cigna of CA PPO |
$12.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.56
|
| Rate for Payer: Galaxy Health WC |
$13.94
|
| Rate for Payer: Global Benefits Group Commercial |
$9.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.76
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.30
|
| Rate for Payer: IEHP medi-cal |
$5.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.28
|
| Rate for Payer: Multiplan Commercial |
$12.30
|
| Rate for Payer: Networks By Design Commercial |
$10.66
|
| Rate for Payer: Prime Health Services Commercial |
$13.94
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.84
|
| Rate for Payer: Riverside University Health MISP |
$6.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.20
|
| Rate for Payer: United Healthcare All Other HMO |
$8.20
|
| Rate for Payer: United Healthcare HMO Rider |
$8.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.94
|
| Rate for Payer: Vantage Medical Group Senior |
$13.94
|
|
|
HC SUTURE VICRYL 4-0 27" 109330
|
Facility
IP
|
$16.40
|
|
| Hospital Charge Code |
901694879
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.28 |
| Max. Negotiated Rate |
$14.76 |
| Rate for Payer: Cash Price |
$7.38
|
| Rate for Payer: Central Health Plan Commercial |
$13.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.56
|
| Rate for Payer: Galaxy Health WC |
$13.94
|
| Rate for Payer: Global Benefits Group Commercial |
$9.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.28
|
| Rate for Payer: Multiplan Commercial |
$12.30
|
| Rate for Payer: Networks By Design Commercial |
$10.66
|
| Rate for Payer: Prime Health Services Commercial |
$13.94
|
|
|
HC SUTURE VICRYL 4-0 27" SH
|
Facility
IP
|
$13.12
|
|
| Hospital Charge Code |
901604301
|
|
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 4-0 27" SH
|
Facility
OP
|
$13.12
|
|
| Hospital Charge Code |
901604301
|
|
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 4-0 CTD ANTIBAC
|
Facility
IP
|
$29.19
|
|
| Hospital Charge Code |
901604397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.84 |
| Max. Negotiated Rate |
$26.27 |
| Rate for Payer: Cash Price |
$13.14
|
| Rate for Payer: Central Health Plan Commercial |
$23.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.68
|
| Rate for Payer: Galaxy Health WC |
$24.81
|
| Rate for Payer: Global Benefits Group Commercial |
$17.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.84
|
| Rate for Payer: Multiplan Commercial |
$21.89
|
| Rate for Payer: Networks By Design Commercial |
$18.97
|
| Rate for Payer: Prime Health Services Commercial |
$24.81
|
|
|
HC SUTURE VICRYL 4-0 CTD ANTIBAC
|
Facility
OP
|
$29.19
|
|
| Hospital Charge Code |
901604397
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.84 |
| Max. Negotiated Rate |
$26.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.81
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.25
|
| Rate for Payer: BCBS Transplant Transplant |
$17.51
|
| Rate for Payer: Blue Shield of California Commercial |
$18.36
|
| Rate for Payer: Blue Shield of California EPN |
$14.27
|
| Rate for Payer: Cash Price |
$13.14
|
| Rate for Payer: Central Health Plan Commercial |
$23.35
|
| Rate for Payer: Cigna of CA HMO |
$18.68
|
| Rate for Payer: Cigna of CA PPO |
$21.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.68
|
| Rate for Payer: Galaxy Health WC |
$24.81
|
| Rate for Payer: Global Benefits Group Commercial |
$17.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.27
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21.89
|
| Rate for Payer: IEHP medi-cal |
$10.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.84
|
| Rate for Payer: Multiplan Commercial |
$21.89
|
| Rate for Payer: Networks By Design Commercial |
$18.97
|
| Rate for Payer: Prime Health Services Commercial |
$24.81
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$17.51
|
| Rate for Payer: Riverside University Health MISP |
$11.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.60
|
| Rate for Payer: United Healthcare All Other HMO |
$14.60
|
| Rate for Payer: United Healthcare HMO Rider |
$14.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.81
|
| Rate for Payer: Vantage Medical Group Senior |
$24.81
|
|
|
HC SUTURE VICRYL 4-0 FS1 117218
|
Facility
IP
|
$14.60
|
|
| Hospital Charge Code |
901694625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$13.14 |
| Rate for Payer: Cash Price |
$6.57
|
| Rate for Payer: Central Health Plan Commercial |
$11.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.84
|
| Rate for Payer: Galaxy Health WC |
$12.41
|
| Rate for Payer: Global Benefits Group Commercial |
$8.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.92
|
| Rate for Payer: Multiplan Commercial |
$10.95
|
| Rate for Payer: Networks By Design Commercial |
$9.49
|
| Rate for Payer: Prime Health Services Commercial |
$12.41
|
|
