|
HC SUTURE MONOCRYL 4-0 227388
|
Facility
|
OP
|
$60.84
|
|
| Hospital Charge Code |
901691009
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.17 |
| Max. Negotiated Rate |
$54.76 |
| Rate for Payer: Adventist Health Commercial |
$12.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.73
|
| Rate for Payer: Blue Shield of California Commercial |
$37.17
|
| Rate for Payer: Blue Shield of California EPN |
$24.28
|
| Rate for Payer: Cash Price |
$33.46
|
| Rate for Payer: Central Health Plan Commercial |
$48.67
|
| Rate for Payer: Cigna of CA HMO |
$38.94
|
| Rate for Payer: Cigna of CA PPO |
$45.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.34
|
| Rate for Payer: EPIC Health Plan Senior |
$24.34
|
| Rate for Payer: Galaxy Health WC |
$51.71
|
| Rate for Payer: Global Benefits Group Commercial |
$36.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.76
|
| Rate for Payer: InnovAge PACE Commercial |
$30.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.59
|
| Rate for Payer: Multiplan Commercial |
$45.63
|
| Rate for Payer: Networks By Design Commercial |
$39.55
|
| Rate for Payer: Prime Health Services Commercial |
$51.71
|
| Rate for Payer: Riverside University Health System MISP |
$24.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.42
|
| Rate for Payer: United Healthcare All Other HMO |
$30.42
|
| Rate for Payer: United Healthcare HMO Rider |
$30.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.71
|
| Rate for Payer: Vantage Medical Group Senior |
$51.71
|
|
|
HC SUTURE MONOCRYL 4-0 PS-2
|
Facility
|
IP
|
$63.14
|
|
| Hospital Charge Code |
901694885
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$56.83 |
| Rate for Payer: Adventist Health Commercial |
$12.63
|
| Rate for Payer: Cash Price |
$34.73
|
| Rate for Payer: Central Health Plan Commercial |
$50.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.26
|
| Rate for Payer: EPIC Health Plan Senior |
$25.26
|
| Rate for Payer: Galaxy Health WC |
$53.67
|
| Rate for Payer: Global Benefits Group Commercial |
$37.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$56.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.63
|
| Rate for Payer: Multiplan Commercial |
$47.35
|
| Rate for Payer: Networks By Design Commercial |
$41.04
|
| Rate for Payer: Prime Health Services Commercial |
$53.67
|
|
|
HC SUTURE MONOCRYL 4-0 PS-2
|
Facility
|
OP
|
$63.14
|
|
| Hospital Charge Code |
901694885
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.63 |
| Max. Negotiated Rate |
$56.83 |
| Rate for Payer: Adventist Health Commercial |
$12.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$53.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.35
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.08
|
| Rate for Payer: Blue Shield of California Commercial |
$38.58
|
| Rate for Payer: Blue Shield of California EPN |
$25.19
|
| Rate for Payer: Cash Price |
$34.73
|
| Rate for Payer: Central Health Plan Commercial |
$50.51
|
| Rate for Payer: Cigna of CA HMO |
$40.41
|
| Rate for Payer: Cigna of CA PPO |
$46.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$53.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$53.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$53.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.26
|
| Rate for Payer: EPIC Health Plan Senior |
$25.26
|
| Rate for Payer: Galaxy Health WC |
$53.67
|
| Rate for Payer: Global Benefits Group Commercial |
$37.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$56.83
|
| Rate for Payer: InnovAge PACE Commercial |
$31.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.20
|
| Rate for Payer: Multiplan Commercial |
$47.35
|
| Rate for Payer: Networks By Design Commercial |
$41.04
|
| Rate for Payer: Prime Health Services Commercial |
$53.67
|
| Rate for Payer: Riverside University Health System MISP |
$25.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$37.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$37.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.57
|
| Rate for Payer: United Healthcare All Other HMO |
$31.57
|
| Rate for Payer: United Healthcare HMO Rider |
$31.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$53.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$53.67
|
| Rate for Payer: Vantage Medical Group Senior |
$53.67
|
|
|
HC SUTURE MONOCRYL 5-0 227404
|
Facility
|
OP
|
$66.01
|
|
| Hospital Charge Code |
901691008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.41 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$49.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$38.77
|
| Rate for Payer: Blue Shield of California Commercial |
$40.33
|
| Rate for Payer: Blue Shield of California EPN |
$26.34
|
| Rate for Payer: Cash Price |
$36.31
|
| Rate for Payer: Central Health Plan Commercial |
$52.81
|
| Rate for Payer: Cigna of CA HMO |
$42.25
|
| Rate for Payer: Cigna of CA PPO |
$48.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.11
|
| Rate for Payer: Global Benefits Group Commercial |
$39.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.41
|
| Rate for Payer: InnovAge PACE Commercial |
$33.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.21
|
| Rate for Payer: Multiplan Commercial |
$49.51
|
| Rate for Payer: Networks By Design Commercial |
$42.91
|
| Rate for Payer: Prime Health Services Commercial |
$56.11
|
| Rate for Payer: Riverside University Health System MISP |
$26.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$39.61
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$39.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.01
|
| Rate for Payer: United Healthcare All Other HMO |
$33.01
|
| Rate for Payer: United Healthcare HMO Rider |
$33.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.11
|
| Rate for Payer: Vantage Medical Group Senior |
$56.11
|
|
|
HC SUTURE MONOCRYL 5-0 227404
|
Facility
|
IP
|
$66.01
|
|
| Hospital Charge Code |
901691008
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.20 |
| Max. Negotiated Rate |
$59.41 |
| Rate for Payer: Adventist Health Commercial |
$13.20
|
| Rate for Payer: Cash Price |
$36.31
|
| Rate for Payer: Central Health Plan Commercial |
$52.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.40
|
| Rate for Payer: EPIC Health Plan Senior |
$26.40
|
| Rate for Payer: Galaxy Health WC |
$56.11
|
| Rate for Payer: Global Benefits Group Commercial |
$39.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$59.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$49.51
|
| Rate for Payer: Networks By Design Commercial |
$42.91
|
| Rate for Payer: Prime Health Services Commercial |
$56.11
|
|
|
HC SUTURE MONOCRYL 5-0 P-3
|
Facility
|
OP
|
$32.96
|
|
| Hospital Charge Code |
901694941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$29.66 |
| Rate for Payer: Adventist Health Commercial |
$6.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$20.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.72
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.36
|
| Rate for Payer: Blue Shield of California Commercial |
$20.14
|
| Rate for Payer: Blue Shield of California EPN |
$13.15
|
| Rate for Payer: Cash Price |
$18.13
|
| Rate for Payer: Central Health Plan Commercial |
$26.37
|
| Rate for Payer: Cigna of CA HMO |
$21.09
|
| Rate for Payer: Cigna of CA PPO |
$24.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$28.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.18
|
| Rate for Payer: EPIC Health Plan Senior |
$13.18
|
| Rate for Payer: Galaxy Health WC |
$28.02
|
| Rate for Payer: Global Benefits Group Commercial |
$19.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.66
|
| Rate for Payer: InnovAge PACE Commercial |
$16.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.07
|
| Rate for Payer: Multiplan Commercial |
$24.72
|
| Rate for Payer: Networks By Design Commercial |
$21.42
|
| Rate for Payer: Prime Health Services Commercial |
$28.02
|
| Rate for Payer: Riverside University Health System MISP |
$13.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.78
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.78
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.48
|
| Rate for Payer: United Healthcare All Other HMO |
$16.48
|
| Rate for Payer: United Healthcare HMO Rider |
$16.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$28.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.02
|
| Rate for Payer: Vantage Medical Group Senior |
$28.02
|
|
|
HC SUTURE MONOCRYL 5-0 P-3
|
Facility
|
IP
|
$32.96
|
|
| Hospital Charge Code |
901694941
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$29.66 |
| Rate for Payer: Adventist Health Commercial |
$6.59
|
| Rate for Payer: Cash Price |
$18.13
|
| Rate for Payer: Central Health Plan Commercial |
$26.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.18
|
| Rate for Payer: EPIC Health Plan Senior |
$13.18
|
| Rate for Payer: Galaxy Health WC |
$28.02
|
| Rate for Payer: Global Benefits Group Commercial |
$19.78
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$21.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$20.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.59
|
| Rate for Payer: Multiplan Commercial |
$24.72
|
| Rate for Payer: Networks By Design Commercial |
$21.42
|
| Rate for Payer: Prime Health Services Commercial |
$28.02
|
|
|
HC SUTURE MONOCRYL 6-0
|
Facility
|
OP
|
$66.83
|
|
| Hospital Charge Code |
901691016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$60.15 |
| Rate for Payer: Adventist Health Commercial |
$13.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$40.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$56.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$36.76
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$50.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$39.25
|
| Rate for Payer: Blue Shield of California Commercial |
$40.83
|
| Rate for Payer: Blue Shield of California EPN |
$26.67
|
| Rate for Payer: Cash Price |
$36.76
|
| Rate for Payer: Central Health Plan Commercial |
$53.46
|
| Rate for Payer: Cigna of CA HMO |
$42.77
|
| Rate for Payer: Cigna of CA PPO |
$49.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$56.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$56.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$56.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.73
|
| Rate for Payer: EPIC Health Plan Senior |
$26.73
|
| Rate for Payer: Galaxy Health WC |
$56.81
|
| Rate for Payer: Global Benefits Group Commercial |
$40.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$60.15
|
| Rate for Payer: InnovAge PACE Commercial |
$33.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$46.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46.78
|
| Rate for Payer: Multiplan Commercial |
$50.12
|
| Rate for Payer: Networks By Design Commercial |
$43.44
|
| Rate for Payer: Prime Health Services Commercial |
$56.81
|
| Rate for Payer: Riverside University Health System MISP |
$26.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$40.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$40.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$33.41
|
| Rate for Payer: United Healthcare All Other HMO |
$33.41
|
| Rate for Payer: United Healthcare HMO Rider |
$33.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$33.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$56.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$56.81
|
| Rate for Payer: Vantage Medical Group Senior |
$56.81
|
|
|
HC SUTURE MONOCRYL 6-0
|
Facility
|
IP
|
$66.83
|
|
| Hospital Charge Code |
901691016
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$13.37 |
| Max. Negotiated Rate |
$60.15 |
| Rate for Payer: Adventist Health Commercial |
$13.37
|
| Rate for Payer: Cash Price |
$36.76
|
| Rate for Payer: Central Health Plan Commercial |
$53.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.73
|
| Rate for Payer: EPIC Health Plan Senior |
$26.73
|
| Rate for Payer: Galaxy Health WC |
$56.81
|
| Rate for Payer: Global Benefits Group Commercial |
$40.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$60.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$44.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.37
|
| Rate for Payer: Multiplan Commercial |
$50.12
|
| Rate for Payer: Networks By Design Commercial |
$43.44
|
| Rate for Payer: Prime Health Services Commercial |
$56.81
|
|
|
HC SUTURE MRSILN 5MM BP1 107254
|
Facility
|
IP
|
$218.75
|
|
| Hospital Charge Code |
901694649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.75 |
| Max. Negotiated Rate |
$196.88 |
| Rate for Payer: Adventist Health Commercial |
$43.75
|
| Rate for Payer: Cash Price |
$120.31
|
| Rate for Payer: Central Health Plan Commercial |
$175.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.50
|
| Rate for Payer: EPIC Health Plan Senior |
$87.50
|
| Rate for Payer: Galaxy Health WC |
$185.94
|
| Rate for Payer: Global Benefits Group Commercial |
$131.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.75
|
| Rate for Payer: Multiplan Commercial |
$164.06
|
| Rate for Payer: Networks By Design Commercial |
$142.19
|
| Rate for Payer: Prime Health Services Commercial |
$185.94
|
|
|
HC SUTURE MRSILN 5MM BP1 107254
|
Facility
|
OP
|
$218.75
|
|
| Hospital Charge Code |
901694649
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$43.75 |
| Max. Negotiated Rate |
$196.88 |
| Rate for Payer: Adventist Health Commercial |
$43.75
|
| Rate for Payer: Aetna of CA HMO/PPO |
$132.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$185.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$120.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$164.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$105.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$128.47
|
| Rate for Payer: Blue Shield of California Commercial |
$133.66
|
| Rate for Payer: Blue Shield of California EPN |
$87.28
|
| Rate for Payer: Cash Price |
$120.31
|
| Rate for Payer: Central Health Plan Commercial |
$175.00
|
| Rate for Payer: Cigna of CA HMO |
$140.00
|
| Rate for Payer: Cigna of CA PPO |
$161.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$185.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$185.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$185.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$87.50
|
| Rate for Payer: EPIC Health Plan Senior |
$87.50
|
| Rate for Payer: Galaxy Health WC |
$185.94
|
| Rate for Payer: Global Benefits Group Commercial |
$131.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$196.88
|
| Rate for Payer: InnovAge PACE Commercial |
$109.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$145.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$83.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$135.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$43.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$153.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$153.12
|
| Rate for Payer: Multiplan Commercial |
$164.06
|
| Rate for Payer: Networks By Design Commercial |
$142.19
|
| Rate for Payer: Prime Health Services Commercial |
$185.94
|
| Rate for Payer: Riverside University Health System MISP |
$87.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$131.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$131.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$109.38
|
| Rate for Payer: United Healthcare All Other HMO |
$109.38
|
| Rate for Payer: United Healthcare HMO Rider |
$109.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$109.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$185.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$185.94
|
| Rate for Payer: Vantage Medical Group Senior |
$185.94
|
|
|
HC SUTURE MRSILN CTX RS22 2152
|
Facility
|
OP
|
$263.83
|
|
| Hospital Charge Code |
901693123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.77 |
| Max. Negotiated Rate |
$237.45 |
| Rate for Payer: Adventist Health Commercial |
$52.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$160.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$224.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$145.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$197.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$127.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$154.95
|
| Rate for Payer: Blue Shield of California Commercial |
$161.20
|
| Rate for Payer: Blue Shield of California EPN |
$105.27
|
| Rate for Payer: Cash Price |
$145.11
|
| Rate for Payer: Central Health Plan Commercial |
$211.06
|
| Rate for Payer: Cigna of CA HMO |
$168.85
|
| Rate for Payer: Cigna of CA PPO |
$195.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$224.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$224.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$224.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.53
|
| Rate for Payer: EPIC Health Plan Senior |
$105.53
|
| Rate for Payer: Galaxy Health WC |
$224.26
|
| Rate for Payer: Global Benefits Group Commercial |
$158.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$237.45
|
| Rate for Payer: InnovAge PACE Commercial |
$131.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$175.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$184.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$184.68
|
| Rate for Payer: Multiplan Commercial |
$197.87
|
| Rate for Payer: Networks By Design Commercial |
$171.49
|
| Rate for Payer: Prime Health Services Commercial |
$224.26
|
| Rate for Payer: Riverside University Health System MISP |
$105.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$158.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$158.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$131.91
|
| Rate for Payer: United Healthcare All Other HMO |
$131.91
|
| Rate for Payer: United Healthcare HMO Rider |
$131.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$131.91
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$224.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$224.26
|
| Rate for Payer: Vantage Medical Group Senior |
$224.26
|
|
|
HC SUTURE MRSILN CTX RS22 2152
|
Facility
|
IP
|
$263.83
|
|
| Hospital Charge Code |
901693123
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$52.77 |
| Max. Negotiated Rate |
$237.45 |
| Rate for Payer: Adventist Health Commercial |
$52.77
|
| Rate for Payer: Cash Price |
$145.11
|
| Rate for Payer: Central Health Plan Commercial |
$211.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$105.53
|
| Rate for Payer: EPIC Health Plan Senior |
$105.53
|
| Rate for Payer: Galaxy Health WC |
$224.26
|
| Rate for Payer: Global Benefits Group Commercial |
$158.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$237.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$175.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$100.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$163.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$52.77
|
| Rate for Payer: Multiplan Commercial |
$197.87
|
| Rate for Payer: Networks By Design Commercial |
$171.49
|
| Rate for Payer: Prime Health Services Commercial |
$224.26
|
|
|
HC SUTURE PDS 0 CI-1 102829
|
Facility
|
OP
|
$27.31
|
|
| Hospital Charge Code |
901694651
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.46 |
| Max. Negotiated Rate |
$24.58 |
| Rate for Payer: Adventist Health Commercial |
$5.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.04
|
| Rate for Payer: Blue Shield of California Commercial |
$16.69
|
| Rate for Payer: Blue Shield of California EPN |
$10.90
|
| Rate for Payer: Cash Price |
$15.02
|
| Rate for Payer: Central Health Plan Commercial |
$21.85
|
| Rate for Payer: Cigna of CA HMO |
$17.48
|
| Rate for Payer: Cigna of CA PPO |
$20.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.92
|
| Rate for Payer: EPIC Health Plan Senior |
$10.92
|
| Rate for Payer: Galaxy Health WC |
$23.21
|
| Rate for Payer: Global Benefits Group Commercial |
$16.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.58
|
| Rate for Payer: InnovAge PACE Commercial |
$13.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.12
|
| Rate for Payer: Multiplan Commercial |
$20.48
|
| Rate for Payer: Networks By Design Commercial |
$17.75
|
| Rate for Payer: Prime Health Services Commercial |
$23.21
|
| Rate for Payer: Riverside University Health System MISP |
$10.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.65
|
| Rate for Payer: United Healthcare All Other HMO |
$13.65
|
| Rate for Payer: United Healthcare HMO Rider |
$13.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.21
|
| Rate for Payer: Vantage Medical Group Senior |
$23.21
|
|
|
HC SUTURE PDS 0 CI-1 102829
|
Facility
|
IP
|
$27.31
|
|
| Hospital Charge Code |
901694651
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.46 |
| Max. Negotiated Rate |
$24.58 |
| Rate for Payer: Adventist Health Commercial |
$5.46
|
| Rate for Payer: Cash Price |
$15.02
|
| Rate for Payer: Central Health Plan Commercial |
$21.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.92
|
| Rate for Payer: EPIC Health Plan Senior |
$10.92
|
| Rate for Payer: Galaxy Health WC |
$23.21
|
| Rate for Payer: Global Benefits Group Commercial |
$16.39
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.41
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.46
|
| Rate for Payer: Multiplan Commercial |
$20.48
|
| Rate for Payer: Networks By Design Commercial |
$17.75
|
| Rate for Payer: Prime Health Services Commercial |
$23.21
|
|
|
HC SUTURE PDS 2-0 CT-1 128263
|
Facility
|
IP
|
$25.75
|
|
| Hospital Charge Code |
901693111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Cash Price |
$14.16
|
| Rate for Payer: Central Health Plan Commercial |
$20.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.15
|
| Rate for Payer: Multiplan Commercial |
$19.31
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
|
|
HC SUTURE PDS 2-0 CT-1 128263
|
Facility
|
OP
|
$25.75
|
|
| Hospital Charge Code |
901693111
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$5.15 |
| Max. Negotiated Rate |
$23.18 |
| Rate for Payer: Adventist Health Commercial |
$5.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$15.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.12
|
| Rate for Payer: Blue Shield of California Commercial |
$15.73
|
| Rate for Payer: Blue Shield of California EPN |
$10.27
|
| Rate for Payer: Cash Price |
$14.16
|
| Rate for Payer: Central Health Plan Commercial |
$20.60
|
| Rate for Payer: Cigna of CA HMO |
$16.48
|
| Rate for Payer: Cigna of CA PPO |
$19.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.30
|
| Rate for Payer: EPIC Health Plan Senior |
$10.30
|
| Rate for Payer: Galaxy Health WC |
$21.89
|
| Rate for Payer: Global Benefits Group Commercial |
$15.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.18
|
| Rate for Payer: InnovAge PACE Commercial |
$12.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.81
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$15.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.02
|
| Rate for Payer: Multiplan Commercial |
$19.31
|
| Rate for Payer: Networks By Design Commercial |
$16.74
|
| Rate for Payer: Prime Health Services Commercial |
$21.89
|
| Rate for Payer: Riverside University Health System MISP |
$10.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.88
|
| Rate for Payer: United Healthcare All Other HMO |
$12.88
|
| Rate for Payer: United Healthcare HMO Rider |
$12.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.89
|
| Rate for Payer: Vantage Medical Group Senior |
$21.89
|
|
|
HC SUTURE PDS II 5-0 18" P-3
|
Facility
|
OP
|
$63.47
|
|
| Hospital Charge Code |
901601970
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.69 |
| Max. Negotiated Rate |
$57.12 |
| Rate for Payer: Adventist Health Commercial |
$12.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$38.55
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$53.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$34.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$47.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$30.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.28
|
| Rate for Payer: Blue Shield of California Commercial |
$38.78
|
| Rate for Payer: Blue Shield of California EPN |
$25.32
|
| Rate for Payer: Cash Price |
$34.91
|
| Rate for Payer: Central Health Plan Commercial |
$50.78
|
| Rate for Payer: Cigna of CA HMO |
$40.62
|
| Rate for Payer: Cigna of CA PPO |
$46.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$53.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$53.95
|
| Rate for Payer: Dignity Health Medicare Advantage |
$53.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.39
|
| Rate for Payer: EPIC Health Plan Senior |
$25.39
|
| Rate for Payer: Galaxy Health WC |
$53.95
|
| Rate for Payer: Global Benefits Group Commercial |
$38.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.12
|
| Rate for Payer: InnovAge PACE Commercial |
$31.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$44.43
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$44.43
|
| Rate for Payer: Multiplan Commercial |
$47.60
|
| Rate for Payer: Networks By Design Commercial |
$41.26
|
| Rate for Payer: Prime Health Services Commercial |
$53.95
|
| Rate for Payer: Riverside University Health System MISP |
$25.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.73
|
| Rate for Payer: United Healthcare All Other HMO |
$31.73
|
| Rate for Payer: United Healthcare HMO Rider |
$31.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$31.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$53.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$53.95
|
| Rate for Payer: Vantage Medical Group Senior |
$53.95
|
|
|
HC SUTURE PDS II 5-0 18" P-3
|
Facility
|
IP
|
$63.47
|
|
| Hospital Charge Code |
901601970
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.69 |
| Max. Negotiated Rate |
$57.12 |
| Rate for Payer: Adventist Health Commercial |
$12.69
|
| Rate for Payer: Cash Price |
$34.91
|
| Rate for Payer: Central Health Plan Commercial |
$50.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.39
|
| Rate for Payer: EPIC Health Plan Senior |
$25.39
|
| Rate for Payer: Galaxy Health WC |
$53.95
|
| Rate for Payer: Global Benefits Group Commercial |
$38.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$57.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$42.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$24.18
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.69
|
| Rate for Payer: Multiplan Commercial |
$47.60
|
| Rate for Payer: Networks By Design Commercial |
$41.26
|
| Rate for Payer: Prime Health Services Commercial |
$53.95
|
|
|
HC SUTURE PDS II CTX 0 132691
|
Facility
|
OP
|
$60.68
|
|
| Hospital Charge Code |
901694652
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$54.61 |
| Rate for Payer: Adventist Health Commercial |
$12.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$51.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$45.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35.64
|
| Rate for Payer: Blue Shield of California Commercial |
$37.08
|
| Rate for Payer: Blue Shield of California EPN |
$24.21
|
| Rate for Payer: Cash Price |
$33.37
|
| Rate for Payer: Central Health Plan Commercial |
$48.54
|
| Rate for Payer: Cigna of CA HMO |
$38.84
|
| Rate for Payer: Cigna of CA PPO |
$44.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$51.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$51.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$51.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.27
|
| Rate for Payer: EPIC Health Plan Senior |
$24.27
|
| Rate for Payer: Galaxy Health WC |
$51.58
|
| Rate for Payer: Global Benefits Group Commercial |
$36.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.61
|
| Rate for Payer: InnovAge PACE Commercial |
$30.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$42.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$42.48
|
| Rate for Payer: Multiplan Commercial |
$45.51
|
| Rate for Payer: Networks By Design Commercial |
$39.44
|
| Rate for Payer: Prime Health Services Commercial |
$51.58
|
| Rate for Payer: Riverside University Health System MISP |
$24.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$36.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$36.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.34
|
| Rate for Payer: United Healthcare All Other HMO |
$30.34
|
| Rate for Payer: United Healthcare HMO Rider |
$30.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$30.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$51.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$51.58
|
| Rate for Payer: Vantage Medical Group Senior |
$51.58
|
|
|
HC SUTURE PDS II CTX 0 132691
|
Facility
|
IP
|
$60.68
|
|
| Hospital Charge Code |
901694652
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$12.14 |
| Max. Negotiated Rate |
$54.61 |
| Rate for Payer: Adventist Health Commercial |
$12.14
|
| Rate for Payer: Cash Price |
$33.37
|
| Rate for Payer: Central Health Plan Commercial |
$48.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$24.27
|
| Rate for Payer: EPIC Health Plan Senior |
$24.27
|
| Rate for Payer: Galaxy Health WC |
$51.58
|
| Rate for Payer: Global Benefits Group Commercial |
$36.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$54.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$40.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.12
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.14
|
| Rate for Payer: Multiplan Commercial |
$45.51
|
| Rate for Payer: Networks By Design Commercial |
$39.44
|
| Rate for Payer: Prime Health Services Commercial |
$51.58
|
|
|
HC SUTURE PERMA-HAND 3-0 18" FS-1
|
Facility
|
OP
|
$12.38
|
|
| Hospital Charge Code |
901698192
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$11.14 |
| Rate for Payer: Adventist Health Commercial |
$2.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.27
|
| Rate for Payer: Blue Shield of California Commercial |
$7.56
|
| Rate for Payer: Blue Shield of California EPN |
$4.94
|
| Rate for Payer: Cash Price |
$6.81
|
| Rate for Payer: Central Health Plan Commercial |
$9.90
|
| Rate for Payer: Cigna of CA HMO |
$7.92
|
| Rate for Payer: Cigna of CA PPO |
$9.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.52
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.52
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.95
|
| Rate for Payer: EPIC Health Plan Senior |
$4.95
|
| Rate for Payer: Galaxy Health WC |
$10.52
|
| Rate for Payer: Global Benefits Group Commercial |
$7.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.14
|
| Rate for Payer: InnovAge PACE Commercial |
$6.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.67
|
| Rate for Payer: Multiplan Commercial |
$9.29
|
| Rate for Payer: Networks By Design Commercial |
$8.05
|
| Rate for Payer: Prime Health Services Commercial |
$10.52
|
| Rate for Payer: Riverside University Health System MISP |
$4.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.19
|
| Rate for Payer: United Healthcare All Other HMO |
$6.19
|
| Rate for Payer: United Healthcare HMO Rider |
$6.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.52
|
| Rate for Payer: Vantage Medical Group Senior |
$10.52
|
|
|
HC SUTURE PERMA-HAND 3-0 18" FS-1
|
Facility
|
IP
|
$12.38
|
|
| Hospital Charge Code |
901698192
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$2.48 |
| Max. Negotiated Rate |
$11.14 |
| Rate for Payer: Adventist Health Commercial |
$2.48
|
| Rate for Payer: Cash Price |
$6.81
|
| Rate for Payer: Central Health Plan Commercial |
$9.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.95
|
| Rate for Payer: EPIC Health Plan Senior |
$4.95
|
| Rate for Payer: Galaxy Health WC |
$10.52
|
| Rate for Payer: Global Benefits Group Commercial |
$7.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.48
|
| Rate for Payer: Multiplan Commercial |
$9.29
|
| Rate for Payer: Networks By Design Commercial |
$8.05
|
| Rate for Payer: Prime Health Services Commercial |
$10.52
|
|
|
HC SUTURE PLAIN 0 54" LIGA TIES
|
Facility
|
OP
|
$37.15
|
|
| Hospital Charge Code |
901694609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.43 |
| Max. Negotiated Rate |
$33.44 |
| Rate for Payer: Adventist Health Commercial |
$7.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.82
|
| Rate for Payer: Blue Shield of California Commercial |
$22.70
|
| Rate for Payer: Blue Shield of California EPN |
$14.82
|
| Rate for Payer: Cash Price |
$20.43
|
| Rate for Payer: Central Health Plan Commercial |
$29.72
|
| Rate for Payer: Cigna of CA HMO |
$23.78
|
| Rate for Payer: Cigna of CA PPO |
$27.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.86
|
| Rate for Payer: EPIC Health Plan Senior |
$14.86
|
| Rate for Payer: Galaxy Health WC |
$31.58
|
| Rate for Payer: Global Benefits Group Commercial |
$22.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.44
|
| Rate for Payer: InnovAge PACE Commercial |
$18.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$26.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$26.00
|
| Rate for Payer: Multiplan Commercial |
$27.86
|
| Rate for Payer: Networks By Design Commercial |
$24.15
|
| Rate for Payer: Prime Health Services Commercial |
$31.58
|
| Rate for Payer: Riverside University Health System MISP |
$14.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.57
|
| Rate for Payer: United Healthcare All Other HMO |
$18.57
|
| Rate for Payer: United Healthcare HMO Rider |
$18.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.58
|
| Rate for Payer: Vantage Medical Group Senior |
$31.58
|
|
|
HC SUTURE PLAIN 0 54" LIGA TIES
|
Facility
|
IP
|
$37.15
|
|
| Hospital Charge Code |
901694609
|
|
Hospital Revenue Code
|
272
|
| Min. Negotiated Rate |
$7.43 |
| Max. Negotiated Rate |
$33.44 |
| Rate for Payer: Adventist Health Commercial |
$7.43
|
| Rate for Payer: Cash Price |
$20.43
|
| Rate for Payer: Central Health Plan Commercial |
$29.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.86
|
| Rate for Payer: EPIC Health Plan Senior |
$14.86
|
| Rate for Payer: Galaxy Health WC |
$31.58
|
| Rate for Payer: Global Benefits Group Commercial |
$22.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$33.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$23.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.43
|
| Rate for Payer: Multiplan Commercial |
$27.86
|
| Rate for Payer: Networks By Design Commercial |
$24.15
|
| Rate for Payer: Prime Health Services Commercial |
$31.58
|
|
