SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION [11403]
|
Facility
OP
|
$0.01
|
|
Service Code
|
NDC 0338-0048-04
|
Hospital Charge Code |
1771075
|
Hospital Revenue Code
|
250
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
Rate for Payer: Dignity Health Media |
$0.01
|
Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION [11403]
|
Facility
IP
|
$0.01
|
|
Service Code
|
NDC 0264-2201-10
|
Hospital Charge Code |
NDG11403A
|
Hospital Revenue Code
|
250
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION [11403]
|
Facility
IP
|
$0.01
|
|
Service Code
|
NDC 0264-7388-60
|
Hospital Charge Code |
NDG11403B
|
Hospital Revenue Code
|
250
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IRRIGATION SOLUTION [11403]
|
Facility
OP
|
$0.01
|
|
Service Code
|
NDC 0264-7388-60
|
Hospital Charge Code |
NDG11403B
|
Hospital Revenue Code
|
250
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
Rate for Payer: Dignity Health Media |
$0.01
|
Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS [400291]
|
Facility
OP
|
$0.01
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771068
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$17.68 |
Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$5.04
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
Rate for Payer: Dignity Health Media |
$0.01
|
Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS [400291]
|
Facility
IP
|
$0.01
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771070
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.02
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS [400291]
|
Facility
OP
|
$0.01
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771070
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$17.68 |
Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.02
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$5.04
|
Rate for Payer: Blue Shield of California EPN |
$5.04
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.02
|
Rate for Payer: Dignity Health Media |
$0.02
|
Rate for Payer: Dignity Health Media |
$0.01
|
Rate for Payer: Dignity Health Medi-Cal |
$0.02
|
Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.02
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.02
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.02
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
Rate for Payer: Vantage Medical Group Senior |
$0.01
|
Rate for Payer: Vantage Medical Group Senior |
$0.02
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS [400291]
|
Facility
IP
|
$0.01
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771069
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS [400291]
|
Facility
IP
|
$0.03
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771073
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.03 |
Rate for Payer: Blue Shield of California Commercial |
$0.02
|
Rate for Payer: Blue Shield of California EPN |
$0.02
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.02
|
Rate for Payer: Cigna of CA PPO |
$0.02
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.03
|
Rate for Payer: Global Benefits Group Commercial |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.02
|
Rate for Payer: Prime Health Services Commercial |
$0.03
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS [400291]
|
Facility
OP
|
$0.03
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771073
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$17.68 |
Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.02
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.02
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
Rate for Payer: BCBS Transplant Transplant |
$0.02
|
Rate for Payer: Blue Shield of California Commercial |
$0.02
|
Rate for Payer: Blue Shield of California EPN |
$5.04
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.02
|
Rate for Payer: Cigna of CA PPO |
$0.02
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.03
|
Rate for Payer: Dignity Health Media |
$0.03
|
Rate for Payer: Dignity Health Medi-Cal |
$0.03
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.03
|
Rate for Payer: Global Benefits Group Commercial |
$0.02
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.02
|
Rate for Payer: Prime Health Services Commercial |
$0.03
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.02
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.02
|
Rate for Payer: United Healthcare All Other Commercial |
$0.02
|
Rate for Payer: United Healthcare All Other HMO |
$0.02
|
Rate for Payer: United Healthcare HMO Rider |
$0.02
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.03
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.03
|
Rate for Payer: Vantage Medical Group Senior |
$0.03
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS [400291]
|
Facility
OP
|
$0.01
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771069
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$17.68 |
Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$5.04
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
Rate for Payer: Dignity Health Media |
$0.01
|
Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS [400291]
|
Facility
IP
|
$0.01
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771068
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS COLD (4 C) [4081020]
|
Facility
IP
|
$0.01
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771068
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS COLD (4 C) [4081020]
|
Facility
IP
|
$0.02
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771070
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$0.02 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.02
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.02
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS COLD (4 C) [4081020]
|
Facility
OP
|
$0.01
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771068
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$17.68 |
Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$5.04
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
Rate for Payer: Dignity Health Media |
$0.01
|
Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS COLD (4 C) [4081020]
|
Facility
IP
|
$0.01
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771069
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS COLD (4 C) [4081020]
|
Facility
OP
|
$0.01
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771069
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$17.68 |
Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$5.04
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
Rate for Payer: Dignity Health Media |
$0.01
|
Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV BOLUS COLD (4 C) [4081020]
|
Facility
OP
|
$0.02
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771070
|
Hospital Revenue Code
|
636
|
Max. Negotiated Rate |
$17.68 |
Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.02
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$5.04
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.02
|
Rate for Payer: Dignity Health Media |
$0.02
|
Rate for Payer: Dignity Health Medi-Cal |
$0.02
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.02
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.02
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.02
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.02
|
Rate for Payer: Vantage Medical Group Senior |
$0.02
|
|
SODIUM CHLORIDE 0.9 % IV FLUSH 250 ML [4080395]
|
Facility
OP
|
$0.01
|
|
Service Code
|
NDC 0264-7800-20
|
Hospital Charge Code |
1771070
|
Hospital Revenue Code
|
250
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
Rate for Payer: Dignity Health Media |
$0.01
|
Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: EPIC Health Plan Transplant |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV FLUSH 250 ML [4080395]
|
Facility
IP
|
$0.02
|
|
Service Code
|
NDC 0338-0049-02
|
Hospital Charge Code |
1771070
|
Hospital Revenue Code
|
250
|
Max. Negotiated Rate |
$0.02 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.02
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.02
|
|
SODIUM CHLORIDE 0.9 % IV FLUSH 250 ML [4080395]
|
Facility
OP
|
$0.02
|
|
Service Code
|
NDC 0338-0049-02
|
Hospital Charge Code |
1771070
|
Hospital Revenue Code
|
250
|
Max. Negotiated Rate |
$0.02 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.01
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.02
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.01
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.01
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
Rate for Payer: BCBS Transplant Transplant |
$0.01
|
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cash Price |
$0.01
|
Rate for Payer: Cigna of CA HMO |
$0.01
|
Rate for Payer: Cigna of CA PPO |
$0.01
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.02
|
Rate for Payer: Dignity Health Media |
$0.02
|
Rate for Payer: Dignity Health Medi-Cal |
$0.02
|
Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
Rate for Payer: EPIC Health Plan Transplant |
$0.01
|
Rate for Payer: Galaxy Health WC |
$0.02
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.02
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.02
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.01
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.01
|
Rate for Payer: United Healthcare All Other Commercial |
$0.01
|
Rate for Payer: United Healthcare All Other HMO |
$0.01
|
Rate for Payer: United Healthcare HMO Rider |
$0.01
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.01
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.02
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.02
|
Rate for Payer: Vantage Medical Group Senior |
$0.02
|
|
SODIUM CHLORIDE 0.9 % IV FLUSH 250 ML [4080395]
|
Facility
IP
|
$0.01
|
|
Service Code
|
NDC 0264-7800-20
|
Hospital Charge Code |
1771070
|
Hospital Revenue Code
|
250
|
Max. Negotiated Rate |
$0.01 |
Rate for Payer: Blue Shield of California Commercial |
$0.01
|
Rate for Payer: Blue Shield of California EPN |
$0.01
|
Rate for Payer: EPIC Health Plan Commercial |
$0.00
|
Rate for Payer: Galaxy Health WC |
$0.01
|
Rate for Payer: Global Benefits Group Commercial |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.01
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.00
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
Rate for Payer: Multiplan Commercial |
$0.01
|
Rate for Payer: Networks By Design Commercial |
$0.01
|
Rate for Payer: Prime Health Services Commercial |
$0.01
|
|
SODIUM CHLORIDE 0.9 % IV FLUSH 50 ML [4081038]
|
Facility
OP
|
$0.07
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771072
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$17.68 |
Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
Rate for Payer: Aetna of CA HMO/PPO |
$4.23
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.06
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.04
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.04
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17.68
|
Rate for Payer: BCBS Transplant Transplant |
$0.04
|
Rate for Payer: BCBS Transplant Transplant |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$5.04
|
Rate for Payer: Blue Shield of California EPN |
$5.04
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA HMO |
$0.05
|
Rate for Payer: Cigna of CA PPO |
$0.05
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.06
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
Rate for Payer: Dignity Health Media |
$0.05
|
Rate for Payer: Dignity Health Media |
$0.06
|
Rate for Payer: Dignity Health Medi-Cal |
$0.06
|
Rate for Payer: Dignity Health Medi-Cal |
$0.05
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: EPIC Health Plan Transplant |
$0.03
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.06
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.75
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.03
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.06
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.04
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.04
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
Rate for Payer: United Healthcare All Other Commercial |
$0.04
|
Rate for Payer: United Healthcare All Other HMO |
$0.04
|
Rate for Payer: United Healthcare All Other HMO |
$0.03
|
Rate for Payer: United Healthcare HMO Rider |
$0.03
|
Rate for Payer: United Healthcare HMO Rider |
$0.04
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.04
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.06
|
Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.06
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
Rate for Payer: Vantage Medical Group Senior |
$0.05
|
Rate for Payer: Vantage Medical Group Senior |
$0.06
|
|
SODIUM CHLORIDE 0.9 % IV FLUSH 50 ML [4081038]
|
Facility
IP
|
$0.06
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1771072
|
Hospital Revenue Code
|
636
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Cigna of CA HMO |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.05
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.06
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.02
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.03
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.06
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
|
SODIUM CHLORIDE 0.9% (NS) 50 ML IV BOLUS - CODE [4080588]
|
Facility
IP
|
$0.08
|
|
Service Code
|
CPT J7050
|
Hospital Charge Code |
1720982
|
Hospital Revenue Code
|
258
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.07 |
Rate for Payer: Blue Shield of California Commercial |
$0.06
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Cigna of CA HMO |
$0.06
|
Rate for Payer: Cigna of CA PPO |
$0.06
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.07
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.07
|
|