|
HC SUTURE CHROMIC 2-0 27" CT-1
|
Facility
|
OP
|
$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: Aetna of CA HMO/PPO |
$19.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.07
|
| Rate for Payer: Blue Shield of California Commercial |
$19.84
|
| Rate for Payer: Blue Shield of California EPN |
$12.96
|
| Rate for Payer: Cash Price |
$17.86
|
| Rate for Payer: Central Health Plan Commercial |
$25.98
|
| Rate for Payer: Cigna of CA HMO |
$20.78
|
| Rate for Payer: Cigna of CA PPO |
$24.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.60
|
| 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: InnovAge PACE Commercial |
$16.23
|
| 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: Molina Healthcare of CA Medi-Cal |
$22.73
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$22.73
|
| 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
|
| Rate for Payer: Riverside University Health System MISP |
$12.99
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.23
|
| Rate for Payer: United Healthcare All Other HMO |
$16.23
|
| Rate for Payer: United Healthcare HMO Rider |
$16.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.60
|
| Rate for Payer: Vantage Medical Group Senior |
$27.60
|
|
|
HC SUTURE CHROMIC 2-0 CT2 107255
|
Facility
|
OP
|
$31.65
|
|
| Hospital Charge Code |
901694868
|
|
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 2-0 CT2 107255
|
Facility
|
IP
|
$31.65
|
|
| Hospital Charge Code |
901694868
|
|
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 3-0 100277
|
Facility
|
IP
|
$30.50
|
|
| Hospital Charge Code |
901694648
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$27.45 |
| Rate for Payer: Adventist Health Commercial |
$6.10
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Central Health Plan Commercial |
$24.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.93
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.10
|
| Rate for Payer: Multiplan Commercial |
$22.88
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.93
|
|
|
HC SUTURE CHROMIC 3-0 100277
|
Facility
|
OP
|
$30.50
|
|
| Hospital Charge Code |
901694648
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.10 |
| Max. Negotiated Rate |
$27.45 |
| Rate for Payer: Adventist Health Commercial |
$6.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.91
|
| Rate for Payer: Blue Shield of California Commercial |
$18.64
|
| Rate for Payer: Blue Shield of California EPN |
$12.17
|
| Rate for Payer: Cash Price |
$16.78
|
| Rate for Payer: Central Health Plan Commercial |
$24.40
|
| Rate for Payer: Cigna of CA HMO |
$19.52
|
| Rate for Payer: Cigna of CA PPO |
$22.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.93
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.93
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.20
|
| Rate for Payer: EPIC Health Plan Senior |
$12.20
|
| Rate for Payer: Galaxy Health WC |
$25.93
|
| Rate for Payer: Global Benefits Group Commercial |
$18.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.45
|
| Rate for Payer: InnovAge PACE Commercial |
$15.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$20.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.35
|
| Rate for Payer: Multiplan Commercial |
$22.88
|
| Rate for Payer: Networks By Design Commercial |
$19.82
|
| Rate for Payer: Prime Health Services Commercial |
$25.93
|
| Rate for Payer: Riverside University Health System MISP |
$12.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.25
|
| Rate for Payer: United Healthcare All Other HMO |
$15.25
|
| Rate for Payer: United Healthcare HMO Rider |
$15.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.93
|
| Rate for Payer: Vantage Medical Group Senior |
$25.93
|
|
|
HC SUTURE CHROMIC 3-0 180173
|
Facility
|
OP
|
$38.38
|
|
| Hospital Charge Code |
901692004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$34.54 |
| Rate for Payer: Adventist Health Commercial |
$7.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$32.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$28.79
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.54
|
| Rate for Payer: Blue Shield of California Commercial |
$23.45
|
| Rate for Payer: Blue Shield of California EPN |
$15.31
|
| Rate for Payer: Cash Price |
$21.11
|
| Rate for Payer: Central Health Plan Commercial |
$30.70
|
| Rate for Payer: Cigna of CA HMO |
$24.56
|
| Rate for Payer: Cigna of CA PPO |
$28.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$32.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$32.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$15.35
|
| Rate for Payer: Galaxy Health WC |
$32.62
|
| Rate for Payer: Global Benefits Group Commercial |
$23.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.54
|
| Rate for Payer: InnovAge PACE Commercial |
$19.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.87
|
| Rate for Payer: Multiplan Commercial |
$28.79
|
| Rate for Payer: Networks By Design Commercial |
$24.95
|
| Rate for Payer: Prime Health Services Commercial |
$32.62
|
| Rate for Payer: Riverside University Health System MISP |
$15.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.19
|
| Rate for Payer: United Healthcare All Other HMO |
$19.19
|
| Rate for Payer: United Healthcare HMO Rider |
$19.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$32.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.62
|
| Rate for Payer: Vantage Medical Group Senior |
$32.62
|
|
|
HC SUTURE CHROMIC 3-0 180173
|
Facility
|
IP
|
$38.38
|
|
| Hospital Charge Code |
901692004
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.68 |
| Max. Negotiated Rate |
$34.54 |
| Rate for Payer: Adventist Health Commercial |
$7.68
|
| Rate for Payer: Cash Price |
$21.11
|
| Rate for Payer: Central Health Plan Commercial |
$30.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.35
|
| Rate for Payer: EPIC Health Plan Senior |
$15.35
|
| Rate for Payer: Galaxy Health WC |
$32.62
|
| Rate for Payer: Global Benefits Group Commercial |
$23.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.68
|
| Rate for Payer: Multiplan Commercial |
$28.79
|
| Rate for Payer: Networks By Design Commercial |
$24.95
|
| Rate for Payer: Prime Health Services Commercial |
$32.62
|
|
|
HC SUTURE CHROMIC 3-0 27" 636H
|
Facility
|
OP
|
$29.93
|
|
| Hospital Charge Code |
901601291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$26.94 |
| Rate for Payer: Adventist Health Commercial |
$5.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.45
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.49
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.58
|
| Rate for Payer: Blue Shield of California Commercial |
$18.29
|
| Rate for Payer: Blue Shield of California EPN |
$11.94
|
| Rate for Payer: Cash Price |
$16.46
|
| Rate for Payer: Central Health Plan Commercial |
$23.94
|
| Rate for Payer: Cigna of CA HMO |
$19.16
|
| Rate for Payer: Cigna of CA PPO |
$22.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: EPIC Health Plan Senior |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.94
|
| Rate for Payer: InnovAge PACE Commercial |
$14.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.95
|
| Rate for Payer: Multiplan Commercial |
$22.45
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
| Rate for Payer: Riverside University Health System MISP |
$11.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.96
|
| Rate for Payer: United Healthcare All Other HMO |
$14.96
|
| Rate for Payer: United Healthcare HMO Rider |
$14.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.44
|
| Rate for Payer: Vantage Medical Group Senior |
$25.44
|
|
|
HC SUTURE CHROMIC 3-0 27" 636H
|
Facility
|
IP
|
$29.93
|
|
| Hospital Charge Code |
901601291
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.99 |
| Max. Negotiated Rate |
$26.94 |
| Rate for Payer: Adventist Health Commercial |
$5.99
|
| Rate for Payer: Cash Price |
$16.46
|
| Rate for Payer: Central Health Plan Commercial |
$23.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.97
|
| Rate for Payer: EPIC Health Plan Senior |
$11.97
|
| Rate for Payer: Galaxy Health WC |
$25.44
|
| Rate for Payer: Global Benefits Group Commercial |
$17.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.99
|
| Rate for Payer: Multiplan Commercial |
$22.45
|
| Rate for Payer: Networks By Design Commercial |
$19.45
|
| Rate for Payer: Prime Health Services Commercial |
$25.44
|
|
|
HC SUTURE CHROMIC 3-0 27" CT-1
|
Facility
|
OP
|
$29.19
|
|
| Hospital Charge Code |
901602881
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.84 |
| Max. Negotiated Rate |
$26.27 |
| Rate for Payer: Adventist Health Commercial |
$5.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.14
|
| Rate for Payer: Blue Shield of California Commercial |
$17.84
|
| Rate for Payer: Blue Shield of California EPN |
$11.65
|
| Rate for Payer: Cash Price |
$16.05
|
| 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: Dignity Health Medi-Cal |
$24.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.68
|
| Rate for Payer: EPIC Health Plan Senior |
$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: InnovAge PACE Commercial |
$14.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.43
|
| 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: Riverside University Health System 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 Commercial/Exchange |
$24.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.81
|
| Rate for Payer: Vantage Medical Group Senior |
$24.81
|
|
|
HC SUTURE CHROMIC 3-0 27" CT-1
|
Facility
|
IP
|
$29.19
|
|
| Hospital Charge Code |
901602881
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.84 |
| Max. Negotiated Rate |
$26.27 |
| Rate for Payer: Adventist Health Commercial |
$5.84
|
| Rate for Payer: Cash Price |
$16.05
|
| Rate for Payer: Central Health Plan Commercial |
$23.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.68
|
| Rate for Payer: EPIC Health Plan Senior |
$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: Kaiser Permanente of CA Medi-Cal |
$11.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.07
|
| 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 CHROMIC 3-0 CT2 104504
|
Facility
|
OP
|
$33.21
|
|
| Hospital Charge Code |
901694620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.64 |
| Max. Negotiated Rate |
$29.89 |
| Rate for Payer: Adventist Health Commercial |
$6.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.50
|
| Rate for Payer: Blue Shield of California Commercial |
$20.29
|
| Rate for Payer: Blue Shield of California EPN |
$13.25
|
| Rate for Payer: Cash Price |
$18.27
|
| Rate for Payer: Central Health Plan Commercial |
$26.57
|
| Rate for Payer: Cigna of CA HMO |
$21.25
|
| Rate for Payer: Cigna of CA PPO |
$24.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.28
|
| Rate for Payer: EPIC Health Plan Senior |
$13.28
|
| Rate for Payer: Galaxy Health WC |
$28.23
|
| Rate for Payer: Global Benefits Group Commercial |
$19.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.89
|
| Rate for Payer: InnovAge PACE Commercial |
$16.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.64
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.25
|
| Rate for Payer: Multiplan Commercial |
$24.91
|
| Rate for Payer: Networks By Design Commercial |
$21.59
|
| Rate for Payer: Prime Health Services Commercial |
$28.23
|
| Rate for Payer: Riverside University Health System MISP |
$13.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.93
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.61
|
| Rate for Payer: United Healthcare All Other HMO |
$16.61
|
| Rate for Payer: United Healthcare HMO Rider |
$16.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.61
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.23
|
| Rate for Payer: Vantage Medical Group Senior |
$28.23
|
|
|
HC SUTURE CHROMIC 3-0 CT2 104504
|
Facility
|
IP
|
$33.21
|
|
| Hospital Charge Code |
901694620
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.64 |
| Max. Negotiated Rate |
$29.89 |
| Rate for Payer: Adventist Health Commercial |
$6.64
|
| Rate for Payer: Cash Price |
$18.27
|
| Rate for Payer: Central Health Plan Commercial |
$26.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.28
|
| Rate for Payer: EPIC Health Plan Senior |
$13.28
|
| Rate for Payer: Galaxy Health WC |
$28.23
|
| Rate for Payer: Global Benefits Group Commercial |
$19.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.89
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.64
|
| Rate for Payer: Multiplan Commercial |
$24.91
|
| Rate for Payer: Networks By Design Commercial |
$21.59
|
| Rate for Payer: Prime Health Services Commercial |
$28.23
|
|
|
HC SUTURE CHROMIC 4-0 FS-2 635G
|
Facility
|
OP
|
$16.81
|
|
| Hospital Charge Code |
901693117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$15.13 |
| Rate for Payer: Adventist Health Commercial |
$3.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.87
|
| Rate for Payer: Blue Shield of California Commercial |
$10.27
|
| Rate for Payer: Blue Shield of California EPN |
$6.71
|
| Rate for Payer: Cash Price |
$9.25
|
| Rate for Payer: Central Health Plan Commercial |
$13.45
|
| Rate for Payer: Cigna of CA HMO |
$10.76
|
| Rate for Payer: Cigna of CA PPO |
$12.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.72
|
| Rate for Payer: EPIC Health Plan Senior |
$6.72
|
| Rate for Payer: Galaxy Health WC |
$14.29
|
| Rate for Payer: Global Benefits Group Commercial |
$10.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.13
|
| Rate for Payer: InnovAge PACE Commercial |
$8.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.77
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.77
|
| Rate for Payer: Multiplan Commercial |
$12.61
|
| Rate for Payer: Networks By Design Commercial |
$10.93
|
| Rate for Payer: Prime Health Services Commercial |
$14.29
|
| Rate for Payer: Riverside University Health System MISP |
$6.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.40
|
| Rate for Payer: United Healthcare All Other HMO |
$8.40
|
| Rate for Payer: United Healthcare HMO Rider |
$8.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.29
|
| Rate for Payer: Vantage Medical Group Senior |
$14.29
|
|
|
HC SUTURE CHROMIC 4-0 FS-2 635G
|
Facility
|
IP
|
$16.81
|
|
| Hospital Charge Code |
901693117
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$15.13 |
| Rate for Payer: Adventist Health Commercial |
$3.36
|
| Rate for Payer: Cash Price |
$9.25
|
| Rate for Payer: Central Health Plan Commercial |
$13.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.72
|
| Rate for Payer: EPIC Health Plan Senior |
$6.72
|
| Rate for Payer: Galaxy Health WC |
$14.29
|
| Rate for Payer: Global Benefits Group Commercial |
$10.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: Multiplan Commercial |
$12.61
|
| Rate for Payer: Networks By Design Commercial |
$10.93
|
| Rate for Payer: Prime Health Services Commercial |
$14.29
|
|
|
HC SUTURE CHROMIC 4-0 PS-2
|
Facility
|
IP
|
$576.35
|
|
| Hospital Charge Code |
901694888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.27 |
| Max. Negotiated Rate |
$518.72 |
| Rate for Payer: Adventist Health Commercial |
$115.27
|
| Rate for Payer: Cash Price |
$316.99
|
| Rate for Payer: Central Health Plan Commercial |
$461.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.54
|
| Rate for Payer: EPIC Health Plan Senior |
$230.54
|
| Rate for Payer: Galaxy Health WC |
$489.90
|
| Rate for Payer: Global Benefits Group Commercial |
$345.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$518.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$384.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$356.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.27
|
| Rate for Payer: Multiplan Commercial |
$432.26
|
| Rate for Payer: Networks By Design Commercial |
$374.63
|
| Rate for Payer: Prime Health Services Commercial |
$489.90
|
|
|
HC SUTURE CHROMIC 4-0 PS-2
|
Facility
|
OP
|
$576.35
|
|
| Hospital Charge Code |
901694888
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$115.27 |
| Max. Negotiated Rate |
$518.72 |
| Rate for Payer: Adventist Health Commercial |
$115.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$350.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$489.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$316.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$432.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$279.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$338.49
|
| Rate for Payer: Blue Shield of California Commercial |
$352.15
|
| Rate for Payer: Blue Shield of California EPN |
$229.96
|
| Rate for Payer: Cash Price |
$316.99
|
| Rate for Payer: Central Health Plan Commercial |
$461.08
|
| Rate for Payer: Cigna of CA HMO |
$368.86
|
| Rate for Payer: Cigna of CA PPO |
$426.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$489.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$489.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$489.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$230.54
|
| Rate for Payer: EPIC Health Plan Senior |
$230.54
|
| Rate for Payer: Galaxy Health WC |
$489.90
|
| Rate for Payer: Global Benefits Group Commercial |
$345.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$518.72
|
| Rate for Payer: InnovAge PACE Commercial |
$288.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$384.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$219.59
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$356.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$115.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$403.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$403.44
|
| Rate for Payer: Multiplan Commercial |
$432.26
|
| Rate for Payer: Networks By Design Commercial |
$374.63
|
| Rate for Payer: Prime Health Services Commercial |
$489.90
|
| Rate for Payer: Riverside University Health System MISP |
$230.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$345.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$345.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$288.18
|
| Rate for Payer: United Healthcare All Other HMO |
$288.18
|
| Rate for Payer: United Healthcare HMO Rider |
$288.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$288.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$489.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$489.90
|
| Rate for Payer: Vantage Medical Group Senior |
$489.90
|
|
|
HC SUTURE CHROMIC CT-2 100063
|
Facility
|
IP
|
$21.24
|
|
| Hospital Charge Code |
901694627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Adventist Health Commercial |
$4.25
|
| Rate for Payer: Cash Price |
$11.68
|
| Rate for Payer: Central Health Plan Commercial |
$16.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Multiplan Commercial |
$15.93
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
|
|
HC SUTURE CHROMIC CT-2 100063
|
Facility
|
OP
|
$21.24
|
|
| Hospital Charge Code |
901694627
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$19.12 |
| Rate for Payer: Adventist Health Commercial |
$4.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$18.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$11.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.47
|
| Rate for Payer: Blue Shield of California Commercial |
$12.98
|
| Rate for Payer: Blue Shield of California EPN |
$8.47
|
| Rate for Payer: Cash Price |
$11.68
|
| Rate for Payer: Central Health Plan Commercial |
$16.99
|
| Rate for Payer: Cigna of CA HMO |
$13.59
|
| Rate for Payer: Cigna of CA PPO |
$15.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$18.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$18.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$18.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.50
|
| Rate for Payer: EPIC Health Plan Senior |
$8.50
|
| Rate for Payer: Galaxy Health WC |
$18.05
|
| Rate for Payer: Global Benefits Group Commercial |
$12.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$19.12
|
| Rate for Payer: InnovAge PACE Commercial |
$10.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$14.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$14.87
|
| Rate for Payer: Multiplan Commercial |
$15.93
|
| Rate for Payer: Networks By Design Commercial |
$13.81
|
| Rate for Payer: Prime Health Services Commercial |
$18.05
|
| Rate for Payer: Riverside University Health System MISP |
$8.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$12.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$12.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.62
|
| Rate for Payer: United Healthcare All Other HMO |
$10.62
|
| Rate for Payer: United Healthcare HMO Rider |
$10.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$18.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$18.05
|
| Rate for Payer: Vantage Medical Group Senior |
$18.05
|
|
|
HC SUTURE CHROMIC GUT 0 102839
|
Facility
|
IP
|
$29.36
|
|
| Hospital Charge Code |
901694631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$26.42 |
| Rate for Payer: Adventist Health Commercial |
$5.87
|
| Rate for Payer: Cash Price |
$16.15
|
| Rate for Payer: Central Health Plan Commercial |
$23.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Senior |
$11.74
|
| Rate for Payer: Galaxy Health WC |
$24.96
|
| Rate for Payer: Global Benefits Group Commercial |
$17.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.87
|
| Rate for Payer: Multiplan Commercial |
$22.02
|
| Rate for Payer: Networks By Design Commercial |
$19.08
|
| Rate for Payer: Prime Health Services Commercial |
$24.96
|
|
|
HC SUTURE CHROMIC GUT 0 102839
|
Facility
|
OP
|
$29.36
|
|
| Hospital Charge Code |
901694631
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.87 |
| Max. Negotiated Rate |
$26.42 |
| Rate for Payer: Adventist Health Commercial |
$5.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$14.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.24
|
| Rate for Payer: Blue Shield of California Commercial |
$17.94
|
| Rate for Payer: Blue Shield of California EPN |
$11.71
|
| Rate for Payer: Cash Price |
$16.15
|
| Rate for Payer: Central Health Plan Commercial |
$23.49
|
| Rate for Payer: Cigna of CA HMO |
$18.79
|
| Rate for Payer: Cigna of CA PPO |
$21.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.96
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.74
|
| Rate for Payer: EPIC Health Plan Senior |
$11.74
|
| Rate for Payer: Galaxy Health WC |
$24.96
|
| Rate for Payer: Global Benefits Group Commercial |
$17.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$26.42
|
| Rate for Payer: InnovAge PACE Commercial |
$14.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$18.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.55
|
| Rate for Payer: Multiplan Commercial |
$22.02
|
| Rate for Payer: Networks By Design Commercial |
$19.08
|
| Rate for Payer: Prime Health Services Commercial |
$24.96
|
| Rate for Payer: Riverside University Health System MISP |
$11.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.68
|
| Rate for Payer: United Healthcare All Other HMO |
$14.68
|
| Rate for Payer: United Healthcare HMO Rider |
$14.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.96
|
| Rate for Payer: Vantage Medical Group Senior |
$24.96
|
|
|
HC SUTURE CHROMIC GUT 0 113342
|
Facility
|
OP
|
$26.97
|
|
| Hospital Charge Code |
901694612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Adventist Health Commercial |
$5.39
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.84
|
| Rate for Payer: Blue Shield of California Commercial |
$16.48
|
| Rate for Payer: Blue Shield of California EPN |
$10.76
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Central Health Plan Commercial |
$21.58
|
| Rate for Payer: Cigna of CA HMO |
$17.26
|
| Rate for Payer: Cigna of CA PPO |
$19.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.79
|
| Rate for Payer: EPIC Health Plan Senior |
$10.79
|
| Rate for Payer: Galaxy Health WC |
$22.92
|
| Rate for Payer: Global Benefits Group Commercial |
$16.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.27
|
| Rate for Payer: InnovAge PACE Commercial |
$13.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.88
|
| Rate for Payer: Multiplan Commercial |
$20.23
|
| Rate for Payer: Networks By Design Commercial |
$17.53
|
| Rate for Payer: Prime Health Services Commercial |
$22.92
|
| Rate for Payer: Riverside University Health System MISP |
$10.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.48
|
| Rate for Payer: United Healthcare All Other HMO |
$13.48
|
| Rate for Payer: United Healthcare HMO Rider |
$13.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.92
|
| Rate for Payer: Vantage Medical Group Senior |
$22.92
|
|
|
HC SUTURE CHROMIC GUT 0 113342
|
Facility
|
IP
|
$26.97
|
|
| Hospital Charge Code |
901694612
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.39 |
| Max. Negotiated Rate |
$24.27 |
| Rate for Payer: Adventist Health Commercial |
$5.39
|
| Rate for Payer: Cash Price |
$14.83
|
| Rate for Payer: Central Health Plan Commercial |
$21.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.79
|
| Rate for Payer: EPIC Health Plan Senior |
$10.79
|
| Rate for Payer: Galaxy Health WC |
$22.92
|
| Rate for Payer: Global Benefits Group Commercial |
$16.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.39
|
| Rate for Payer: Multiplan Commercial |
$20.23
|
| Rate for Payer: Networks By Design Commercial |
$17.53
|
| Rate for Payer: Prime Health Services Commercial |
$22.92
|
|
|
HC SUTURE CHROMIC GUT 0 18"210353
|
Facility
|
OP
|
$179.06
|
|
| Hospital Charge Code |
901693102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$161.15 |
| Rate for Payer: Adventist Health Commercial |
$35.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$108.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$152.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$98.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$134.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$86.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.16
|
| Rate for Payer: Blue Shield of California Commercial |
$109.41
|
| Rate for Payer: Blue Shield of California EPN |
$71.44
|
| Rate for Payer: Cash Price |
$98.48
|
| Rate for Payer: Central Health Plan Commercial |
$143.25
|
| Rate for Payer: Cigna of CA HMO |
$114.60
|
| Rate for Payer: Cigna of CA PPO |
$132.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$152.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$152.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$152.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.62
|
| Rate for Payer: EPIC Health Plan Senior |
$71.62
|
| Rate for Payer: Galaxy Health WC |
$152.20
|
| Rate for Payer: Global Benefits Group Commercial |
$107.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.15
|
| Rate for Payer: InnovAge PACE Commercial |
$89.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$110.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.81
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$125.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$125.34
|
| Rate for Payer: Multiplan Commercial |
$134.29
|
| Rate for Payer: Networks By Design Commercial |
$116.39
|
| Rate for Payer: Prime Health Services Commercial |
$152.20
|
| Rate for Payer: Riverside University Health System MISP |
$71.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$107.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$107.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$89.53
|
| Rate for Payer: United Healthcare All Other HMO |
$89.53
|
| Rate for Payer: United Healthcare HMO Rider |
$89.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$89.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$152.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$152.20
|
| Rate for Payer: Vantage Medical Group Senior |
$152.20
|
|
|
HC SUTURE CHROMIC GUT 0 18"210353
|
Facility
|
IP
|
$179.06
|
|
| Hospital Charge Code |
901693102
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$35.81 |
| Max. Negotiated Rate |
$161.15 |
| Rate for Payer: Adventist Health Commercial |
$35.81
|
| Rate for Payer: Cash Price |
$98.48
|
| Rate for Payer: Central Health Plan Commercial |
$143.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$71.62
|
| Rate for Payer: EPIC Health Plan Senior |
$71.62
|
| Rate for Payer: Galaxy Health WC |
$152.20
|
| Rate for Payer: Global Benefits Group Commercial |
$107.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$161.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$119.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$68.22
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$110.84
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$35.81
|
| Rate for Payer: Multiplan Commercial |
$134.29
|
| Rate for Payer: Networks By Design Commercial |
$116.39
|
| Rate for Payer: Prime Health Services Commercial |
$152.20
|
|
