|
HC SUTURE VICRYL 4-0 FS1 117218
|
Facility
OP
|
$14.60
|
|
| Hospital Charge Code |
901694625
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.92 |
| Max. Negotiated Rate |
$13.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.41
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.03
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.63
|
| Rate for Payer: BCBS Transplant Transplant |
$8.76
|
| Rate for Payer: Blue Shield of California Commercial |
$9.18
|
| Rate for Payer: Blue Shield of California EPN |
$7.14
|
| Rate for Payer: Cash Price |
$6.57
|
| Rate for Payer: Central Health Plan Commercial |
$11.68
|
| Rate for Payer: Cigna of CA HMO |
$9.34
|
| Rate for Payer: Cigna of CA PPO |
$10.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$10.95
|
| Rate for Payer: IEHP medi-cal |
$5.11
|
| 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
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.76
|
| Rate for Payer: Riverside University Health MISP |
$5.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.30
|
| Rate for Payer: United Healthcare All Other HMO |
$7.30
|
| Rate for Payer: United Healthcare HMO Rider |
$7.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.41
|
| Rate for Payer: Vantage Medical Group Senior |
$12.41
|
|
|
HC SUTURE VICRYL 4-0 PS-2 119576
|
Facility
OP
|
$45.43
|
|
| Hospital Charge Code |
901694892
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$40.89 |
| Rate for Payer: Aetna of CA HMO/PPO |
$27.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$38.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$24.99
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$24.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$26.84
|
| Rate for Payer: BCBS Transplant Transplant |
$27.26
|
| Rate for Payer: Blue Shield of California Commercial |
$28.58
|
| Rate for Payer: Blue Shield of California EPN |
$22.22
|
| Rate for Payer: Cash Price |
$20.44
|
| Rate for Payer: Central Health Plan Commercial |
$36.34
|
| Rate for Payer: Cigna of CA HMO |
$29.08
|
| Rate for Payer: Cigna of CA PPO |
$33.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$18.17
|
| Rate for Payer: Galaxy Health WC |
$38.62
|
| Rate for Payer: Global Benefits Group Commercial |
$27.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.89
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$34.07
|
| Rate for Payer: IEHP medi-cal |
$15.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.09
|
| Rate for Payer: Multiplan Commercial |
$34.07
|
| Rate for Payer: Networks By Design Commercial |
$29.53
|
| Rate for Payer: Prime Health Services Commercial |
$38.62
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$27.26
|
| Rate for Payer: Riverside University Health MISP |
$18.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$27.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$27.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$22.72
|
| Rate for Payer: United Healthcare All Other HMO |
$22.72
|
| Rate for Payer: United Healthcare HMO Rider |
$22.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$22.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$38.62
|
| Rate for Payer: Vantage Medical Group Senior |
$38.62
|
|
|
HC SUTURE VICRYL 4-0 PS-2 119576
|
Facility
IP
|
$45.43
|
|
| Hospital Charge Code |
901694892
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.09 |
| Max. Negotiated Rate |
$40.89 |
| Rate for Payer: Cash Price |
$20.44
|
| Rate for Payer: Central Health Plan Commercial |
$36.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.17
|
| Rate for Payer: Galaxy Health WC |
$38.62
|
| Rate for Payer: Global Benefits Group Commercial |
$27.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$40.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$30.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.09
|
| Rate for Payer: Multiplan Commercial |
$34.07
|
| Rate for Payer: Networks By Design Commercial |
$29.53
|
| Rate for Payer: Prime Health Services Commercial |
$38.62
|
|
|
HC SUTURE VICRYL 4-0 +UD BR
|
Facility
IP
|
$31.08
|
|
| Hospital Charge Code |
901603304
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.22 |
| Max. Negotiated Rate |
$27.97 |
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: Central Health Plan Commercial |
$24.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.43
|
| Rate for Payer: Galaxy Health WC |
$26.42
|
| Rate for Payer: Global Benefits Group Commercial |
$18.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.22
|
| Rate for Payer: Multiplan Commercial |
$23.31
|
| Rate for Payer: Networks By Design Commercial |
$20.20
|
| Rate for Payer: Prime Health Services Commercial |
$26.42
|
|
|
HC SUTURE VICRYL 4-0 +UD BR
|
Facility
OP
|
$31.08
|
|
| Hospital Charge Code |
901603304
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.22 |
| Max. Negotiated Rate |
$27.97 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$26.42
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.09
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.36
|
| Rate for Payer: BCBS Transplant Transplant |
$18.65
|
| Rate for Payer: Blue Shield of California Commercial |
$19.55
|
| Rate for Payer: Blue Shield of California EPN |
$15.20
|
| Rate for Payer: Cash Price |
$13.99
|
| Rate for Payer: Central Health Plan Commercial |
$24.86
|
| Rate for Payer: Cigna of CA HMO |
$19.89
|
| Rate for Payer: Cigna of CA PPO |
$23.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.43
|
| Rate for Payer: Galaxy Health WC |
$26.42
|
| Rate for Payer: Global Benefits Group Commercial |
$18.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.97
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$23.31
|
| Rate for Payer: IEHP medi-cal |
$10.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.22
|
| Rate for Payer: Multiplan Commercial |
$23.31
|
| Rate for Payer: Networks By Design Commercial |
$20.20
|
| Rate for Payer: Prime Health Services Commercial |
$26.42
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.65
|
| Rate for Payer: Riverside University Health MISP |
$12.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.54
|
| Rate for Payer: United Healthcare All Other HMO |
$15.54
|
| Rate for Payer: United Healthcare HMO Rider |
$15.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.42
|
| Rate for Payer: Vantage Medical Group Senior |
$26.42
|
|
|
HC SUTURE VICRYL 5-0 18" BR
|
Facility
IP
|
$30.09
|
|
| Hospital Charge Code |
901604010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$27.08 |
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Central Health Plan Commercial |
$24.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.02
|
| Rate for Payer: Multiplan Commercial |
$22.57
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
|
|
HC SUTURE VICRYL 5-0 18" BR
|
Facility
OP
|
$30.09
|
|
| Hospital Charge Code |
901604010
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.02 |
| Max. Negotiated Rate |
$27.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.27
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.55
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.78
|
| Rate for Payer: BCBS Transplant Transplant |
$18.05
|
| Rate for Payer: Blue Shield of California Commercial |
$18.93
|
| Rate for Payer: Blue Shield of California EPN |
$14.71
|
| Rate for Payer: Cash Price |
$13.54
|
| Rate for Payer: Central Health Plan Commercial |
$24.07
|
| Rate for Payer: Cigna of CA HMO |
$19.26
|
| Rate for Payer: Cigna of CA PPO |
$22.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.04
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.04
|
| Rate for Payer: Galaxy Health WC |
$25.58
|
| Rate for Payer: Global Benefits Group Commercial |
$18.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.08
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.57
|
| Rate for Payer: IEHP medi-cal |
$10.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.02
|
| Rate for Payer: Multiplan Commercial |
$22.57
|
| Rate for Payer: Networks By Design Commercial |
$19.56
|
| Rate for Payer: Prime Health Services Commercial |
$25.58
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.05
|
| Rate for Payer: Riverside University Health MISP |
$12.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.04
|
| Rate for Payer: United Healthcare All Other HMO |
$15.04
|
| Rate for Payer: United Healthcare HMO Rider |
$15.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.58
|
| Rate for Payer: Vantage Medical Group Senior |
$25.58
|
|
|
HC SUTURE VICRYL 5-0 18" PS-2
|
Facility
OP
|
$31.41
|
|
| Hospital Charge Code |
901604384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$28.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19.08
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$26.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.28
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.56
|
| Rate for Payer: BCBS Transplant Transplant |
$18.85
|
| Rate for Payer: Blue Shield of California Commercial |
$19.76
|
| Rate for Payer: Blue Shield of California EPN |
$15.36
|
| Rate for Payer: Cash Price |
$14.13
|
| Rate for Payer: Central Health Plan Commercial |
$25.13
|
| Rate for Payer: Cigna of CA HMO |
$20.10
|
| Rate for Payer: Cigna of CA PPO |
$23.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$26.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.56
|
| Rate for Payer: Galaxy Health WC |
$26.70
|
| Rate for Payer: Global Benefits Group Commercial |
$18.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.27
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$23.56
|
| Rate for Payer: IEHP medi-cal |
$10.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.28
|
| Rate for Payer: Multiplan Commercial |
$23.56
|
| Rate for Payer: Networks By Design Commercial |
$20.42
|
| Rate for Payer: Prime Health Services Commercial |
$26.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.85
|
| Rate for Payer: Riverside University Health MISP |
$12.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.85
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.70
|
| Rate for Payer: United Healthcare All Other HMO |
$15.70
|
| Rate for Payer: United Healthcare HMO Rider |
$15.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$26.70
|
| Rate for Payer: Vantage Medical Group Senior |
$26.70
|
|
|
HC SUTURE VICRYL 5-0 18" PS-2
|
Facility
IP
|
$31.41
|
|
| Hospital Charge Code |
901604384
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.28 |
| Max. Negotiated Rate |
$28.27 |
| Rate for Payer: Cash Price |
$14.13
|
| Rate for Payer: Central Health Plan Commercial |
$25.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.56
|
| Rate for Payer: Galaxy Health WC |
$26.70
|
| Rate for Payer: Global Benefits Group Commercial |
$18.85
|
| Rate for Payer: Health Management Network EPO/PPO |
$28.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.28
|
| Rate for Payer: Multiplan Commercial |
$23.56
|
| Rate for Payer: Networks By Design Commercial |
$20.42
|
| Rate for Payer: Prime Health Services Commercial |
$26.70
|
|
|
HC SUTURE VICRYL 5-0 P-3
|
Facility
IP
|
$32.30
|
|
| Hospital Charge Code |
901694942
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$29.07 |
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Central Health Plan Commercial |
$25.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.92
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.46
|
| Rate for Payer: Multiplan Commercial |
$24.22
|
| Rate for Payer: Networks By Design Commercial |
$21.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.46
|
|
|
HC SUTURE VICRYL 5-0 P-3
|
Facility
OP
|
$32.30
|
|
| Hospital Charge Code |
901694942
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.46 |
| Max. Negotiated Rate |
$29.07 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19.62
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$27.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$17.76
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.76
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.08
|
| Rate for Payer: BCBS Transplant Transplant |
$19.38
|
| Rate for Payer: Blue Shield of California Commercial |
$20.32
|
| Rate for Payer: Blue Shield of California EPN |
$15.79
|
| Rate for Payer: Cash Price |
$14.54
|
| Rate for Payer: Central Health Plan Commercial |
$25.84
|
| Rate for Payer: Cigna of CA HMO |
$20.67
|
| Rate for Payer: Cigna of CA PPO |
$23.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.92
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.92
|
| Rate for Payer: Galaxy Health WC |
$27.46
|
| Rate for Payer: Global Benefits Group Commercial |
$19.38
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.07
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$24.22
|
| Rate for Payer: IEHP medi-cal |
$11.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.46
|
| Rate for Payer: Multiplan Commercial |
$24.22
|
| Rate for Payer: Networks By Design Commercial |
$21.00
|
| Rate for Payer: Prime Health Services Commercial |
$27.46
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$19.38
|
| Rate for Payer: Riverside University Health MISP |
$12.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.15
|
| Rate for Payer: United Healthcare All Other HMO |
$16.15
|
| Rate for Payer: United Healthcare HMO Rider |
$16.15
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.46
|
| Rate for Payer: Vantage Medical Group Senior |
$27.46
|
|
|
HC SUTURE VICRYL 5-0 RAPIDE PC1
|
Facility
IP
|
$49.12
|
|
| Hospital Charge Code |
901694943
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$44.21 |
| Rate for Payer: Cash Price |
$22.10
|
| Rate for Payer: Central Health Plan Commercial |
$39.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.65
|
| Rate for Payer: Galaxy Health WC |
$41.75
|
| Rate for Payer: Global Benefits Group Commercial |
$29.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.82
|
| Rate for Payer: Multiplan Commercial |
$36.84
|
| Rate for Payer: Networks By Design Commercial |
$31.93
|
| Rate for Payer: Prime Health Services Commercial |
$41.75
|
|
|
HC SUTURE VICRYL 5-0 RAPIDE PC1
|
Facility
OP
|
$49.12
|
|
| Hospital Charge Code |
901694943
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$9.82 |
| Max. Negotiated Rate |
$44.21 |
| Rate for Payer: Aetna of CA HMO/PPO |
$29.83
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$41.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$27.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$23.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.02
|
| Rate for Payer: BCBS Transplant Transplant |
$29.47
|
| Rate for Payer: Blue Shield of California Commercial |
$30.90
|
| Rate for Payer: Blue Shield of California EPN |
$24.02
|
| Rate for Payer: Cash Price |
$22.10
|
| Rate for Payer: Central Health Plan Commercial |
$39.30
|
| Rate for Payer: Cigna of CA HMO |
$31.44
|
| Rate for Payer: Cigna of CA PPO |
$36.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.65
|
| Rate for Payer: EPIC Health Plan Transplant |
$19.65
|
| Rate for Payer: Galaxy Health WC |
$41.75
|
| Rate for Payer: Global Benefits Group Commercial |
$29.47
|
| Rate for Payer: Health Management Network EPO/PPO |
$44.21
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$36.84
|
| Rate for Payer: IEHP medi-cal |
$17.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.82
|
| Rate for Payer: Multiplan Commercial |
$36.84
|
| Rate for Payer: Networks By Design Commercial |
$31.93
|
| Rate for Payer: Prime Health Services Commercial |
$41.75
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$29.47
|
| Rate for Payer: Riverside University Health MISP |
$19.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$29.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$29.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$24.56
|
| Rate for Payer: United Healthcare All Other HMO |
$24.56
|
| Rate for Payer: United Healthcare HMO Rider |
$24.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$24.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$41.75
|
| Rate for Payer: Vantage Medical Group Senior |
$41.75
|
|
|
HC SUTURE VICRYL 6-0 100809
|
Facility
IP
|
$82.00
|
|
| Hospital Charge Code |
901693115
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
|
|
HC SUTURE VICRYL 6-0 100809
|
Facility
OP
|
$82.00
|
|
| Hospital Charge Code |
901693115
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$16.40 |
| Max. Negotiated Rate |
$73.80 |
| Rate for Payer: Aetna of CA HMO/PPO |
$49.80
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$69.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45.10
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$45.10
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$39.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.45
|
| Rate for Payer: BCBS Transplant Transplant |
$49.20
|
| Rate for Payer: Blue Shield of California Commercial |
$51.58
|
| Rate for Payer: Blue Shield of California EPN |
$40.10
|
| Rate for Payer: Cash Price |
$36.90
|
| Rate for Payer: Central Health Plan Commercial |
$65.60
|
| Rate for Payer: Cigna of CA HMO |
$52.48
|
| Rate for Payer: Cigna of CA PPO |
$60.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$32.80
|
| Rate for Payer: Galaxy Health WC |
$69.70
|
| Rate for Payer: Global Benefits Group Commercial |
$49.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.80
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$61.50
|
| Rate for Payer: IEHP medi-cal |
$28.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$54.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.40
|
| Rate for Payer: Multiplan Commercial |
$61.50
|
| Rate for Payer: Networks By Design Commercial |
$53.30
|
| Rate for Payer: Prime Health Services Commercial |
$69.70
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: Riverside University Health MISP |
$32.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.00
|
| Rate for Payer: United Healthcare All Other HMO |
$41.00
|
| Rate for Payer: United Healthcare HMO Rider |
$41.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.70
|
| Rate for Payer: Vantage Medical Group Senior |
$69.70
|
|
|
HC SUTURE VICRYL 6-0 18" BR
|
Facility
OP
|
$30.34
|
|
| Hospital Charge Code |
901601962
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$27.31 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$25.79
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.69
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.92
|
| Rate for Payer: BCBS Transplant Transplant |
$18.20
|
| Rate for Payer: Blue Shield of California Commercial |
$19.08
|
| Rate for Payer: Blue Shield of California EPN |
$14.84
|
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA PPO |
$22.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$22.76
|
| Rate for Payer: IEHP medi-cal |
$10.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.76
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: Riverside University Health MISP |
$12.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.17
|
| Rate for Payer: United Healthcare All Other HMO |
$15.17
|
| Rate for Payer: United Healthcare HMO Rider |
$15.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.79
|
| Rate for Payer: Vantage Medical Group Senior |
$25.79
|
|
|
HC SUTURE VICRYL 6-0 18" BR
|
Facility
IP
|
$30.34
|
|
| Hospital Charge Code |
901601962
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.07 |
| Max. Negotiated Rate |
$27.31 |
| Rate for Payer: Cash Price |
$13.65
|
| Rate for Payer: Central Health Plan Commercial |
$24.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.14
|
| Rate for Payer: Galaxy Health WC |
$25.79
|
| Rate for Payer: Global Benefits Group Commercial |
$18.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.07
|
| Rate for Payer: Multiplan Commercial |
$22.76
|
| Rate for Payer: Networks By Design Commercial |
$19.72
|
| Rate for Payer: Prime Health Services Commercial |
$25.79
|
|
|
HC SUTURE VICRYL+ANTIBAC 210331
|
Facility
OP
|
$11.81
|
|
| Hospital Charge Code |
901693106
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.36 |
| Max. Negotiated Rate |
$10.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.04
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.50
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.98
|
| Rate for Payer: BCBS Transplant Transplant |
$7.09
|
| Rate for Payer: Blue Shield of California Commercial |
$7.43
|
| Rate for Payer: Blue Shield of California EPN |
$5.78
|
| Rate for Payer: Cash Price |
$5.31
|
| Rate for Payer: Central Health Plan Commercial |
$9.45
|
| Rate for Payer: Cigna of CA HMO |
$7.56
|
| Rate for Payer: Cigna of CA PPO |
$8.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.72
|
| Rate for Payer: Galaxy Health WC |
$10.04
|
| Rate for Payer: Global Benefits Group Commercial |
$7.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.63
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.86
|
| Rate for Payer: IEHP medi-cal |
$4.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.36
|
| Rate for Payer: Multiplan Commercial |
$8.86
|
| Rate for Payer: Networks By Design Commercial |
$7.68
|
| Rate for Payer: Prime Health Services Commercial |
$10.04
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.09
|
| Rate for Payer: Riverside University Health MISP |
$4.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.90
|
| Rate for Payer: United Healthcare All Other HMO |
$5.90
|
| Rate for Payer: United Healthcare HMO Rider |
$5.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.04
|
| Rate for Payer: Vantage Medical Group Senior |
$10.04
|
|
|
HC SUTURE VICRYL+ANTIBAC 210331
|
Facility
IP
|
$11.81
|
|
| Hospital Charge Code |
901693106
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.36 |
| Max. Negotiated Rate |
$10.63 |
| Rate for Payer: Cash Price |
$5.31
|
| Rate for Payer: Central Health Plan Commercial |
$9.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.72
|
| Rate for Payer: Galaxy Health WC |
$10.04
|
| Rate for Payer: Global Benefits Group Commercial |
$7.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.36
|
| Rate for Payer: Multiplan Commercial |
$8.86
|
| Rate for Payer: Networks By Design Commercial |
$7.68
|
| Rate for Payer: Prime Health Services Commercial |
$10.04
|
|
|
HC SUTURE VICRYL+ ATBC 1-0 27"
|
Facility
OP
|
$12.30
|
|
| Hospital Charge Code |
901693107
|
|
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+ ATBC 1-0 27"
|
Facility
IP
|
$12.30
|
|
| Hospital Charge Code |
901693107
|
|
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 PLUS 0
|
Facility
OP
|
$14.55
|
|
| Hospital Charge Code |
901695000
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$13.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.37
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.60
|
| Rate for Payer: BCBS Transplant Transplant |
$8.73
|
| Rate for Payer: Blue Shield of California Commercial |
$9.15
|
| Rate for Payer: Blue Shield of California EPN |
$7.11
|
| Rate for Payer: Cash Price |
$6.55
|
| Rate for Payer: Central Health Plan Commercial |
$11.64
|
| Rate for Payer: Cigna of CA HMO |
$9.31
|
| Rate for Payer: Cigna of CA PPO |
$10.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.82
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.82
|
| Rate for Payer: Galaxy Health WC |
$12.37
|
| Rate for Payer: Global Benefits Group Commercial |
$8.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.91
|
| Rate for Payer: IEHP medi-cal |
$5.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.91
|
| Rate for Payer: Multiplan Commercial |
$10.91
|
| Rate for Payer: Networks By Design Commercial |
$9.46
|
| Rate for Payer: Prime Health Services Commercial |
$12.37
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.73
|
| Rate for Payer: Riverside University Health MISP |
$5.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.28
|
| Rate for Payer: United Healthcare All Other HMO |
$7.28
|
| Rate for Payer: United Healthcare HMO Rider |
$7.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.37
|
| Rate for Payer: Vantage Medical Group Senior |
$12.37
|
|
|
HC SUTURE VICRYL PLUS 0
|
Facility
IP
|
$14.55
|
|
| Hospital Charge Code |
901695000
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.91 |
| Max. Negotiated Rate |
$13.10 |
| Rate for Payer: Cash Price |
$6.55
|
| Rate for Payer: Central Health Plan Commercial |
$11.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.82
|
| Rate for Payer: Galaxy Health WC |
$12.37
|
| Rate for Payer: Global Benefits Group Commercial |
$8.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.91
|
| Rate for Payer: Multiplan Commercial |
$10.91
|
| Rate for Payer: Networks By Design Commercial |
$9.46
|
| Rate for Payer: Prime Health Services Commercial |
$12.37
|
|
|
HC SUTURE VICRYL PLUS 3-0 SH
|
Facility
OP
|
$128.59
|
|
| Hospital Charge Code |
901694887
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.72 |
| Max. Negotiated Rate |
$115.73 |
| Rate for Payer: Aetna of CA HMO/PPO |
$78.09
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$109.30
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$70.72
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$70.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$62.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.97
|
| Rate for Payer: BCBS Transplant Transplant |
$77.15
|
| Rate for Payer: Blue Shield of California Commercial |
$80.88
|
| Rate for Payer: Blue Shield of California EPN |
$62.88
|
| Rate for Payer: Cash Price |
$57.87
|
| Rate for Payer: Central Health Plan Commercial |
$102.87
|
| Rate for Payer: Cigna of CA HMO |
$82.30
|
| Rate for Payer: Cigna of CA PPO |
$95.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$109.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$51.44
|
| Rate for Payer: Galaxy Health WC |
$109.30
|
| Rate for Payer: Global Benefits Group Commercial |
$77.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.73
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$96.44
|
| Rate for Payer: IEHP medi-cal |
$45.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.72
|
| Rate for Payer: Multiplan Commercial |
$96.44
|
| Rate for Payer: Networks By Design Commercial |
$83.58
|
| Rate for Payer: Prime Health Services Commercial |
$109.30
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$77.15
|
| Rate for Payer: Riverside University Health MISP |
$51.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$77.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$77.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$64.30
|
| Rate for Payer: United Healthcare All Other HMO |
$64.30
|
| Rate for Payer: United Healthcare HMO Rider |
$64.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$64.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$109.30
|
| Rate for Payer: Vantage Medical Group Senior |
$109.30
|
|
|
HC SUTURE VICRYL PLUS 3-0 SH
|
Facility
IP
|
$128.59
|
|
| Hospital Charge Code |
901694887
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$25.72 |
| Max. Negotiated Rate |
$115.73 |
| Rate for Payer: Cash Price |
$57.87
|
| Rate for Payer: Central Health Plan Commercial |
$102.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.44
|
| Rate for Payer: Galaxy Health WC |
$109.30
|
| Rate for Payer: Global Benefits Group Commercial |
$77.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$115.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$85.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.72
|
| Rate for Payer: Multiplan Commercial |
$96.44
|
| Rate for Payer: Networks By Design Commercial |
$83.58
|
| Rate for Payer: Prime Health Services Commercial |
$109.30
|
|
