|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C
|
Facility
IP
|
$9,715.02
|
|
|
Service Code
|
APR-DRG 5411
|
| Min. Negotiated Rate |
$7,452.45 |
| Max. Negotiated Rate |
$9,715.02 |
| Rate for Payer: IEHP Medi-Cal |
$7,452.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,715.02
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
IP
|
$3.84
|
|
|
Service Code
|
NDC 68084-215-11
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$3.26 |
| Rate for Payer: Blue Shield of California Commercial |
$2.73
|
| Rate for Payer: Blue Shield of California EPN |
$1.97
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cigna of CA HMO |
$2.69
|
| Rate for Payer: Cigna of CA PPO |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.26
|
| Rate for Payer: Global Benefits Group Commercial |
$2.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.07
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.26
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
OP
|
$0.47
|
|
|
Service Code
|
NDC 0378-4275-77
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.28
|
| Rate for Payer: BCBS Transplant Transplant |
$0.28
|
| Rate for Payer: Blue Shield of California Commercial |
$0.35
|
| Rate for Payer: Blue Shield of California EPN |
$0.27
|
| Rate for Payer: Cash Price |
$0.21
|
| Rate for Payer: Cigna of CA HMO |
$0.33
|
| Rate for Payer: Cigna of CA PPO |
$0.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.40
|
| Rate for Payer: Dignity Health Media |
$0.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.19
|
| Rate for Payer: Galaxy Health WC |
$0.40
|
| Rate for Payer: Global Benefits Group Commercial |
$0.28
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: Multiplan Commercial |
$0.38
|
| Rate for Payer: Networks By Design Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$0.40
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.24
|
| Rate for Payer: United Healthcare All Other HMO |
$0.24
|
| Rate for Payer: United Healthcare HMO Rider |
$0.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.40
|
| Rate for Payer: Vantage Medical Group Senior |
$0.40
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
OP
|
$0.98
|
|
|
Service Code
|
NDC 63304-904-30
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.54
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.58
|
| Rate for Payer: BCBS Transplant Transplant |
$0.59
|
| Rate for Payer: Blue Shield of California Commercial |
$0.72
|
| Rate for Payer: Blue Shield of California EPN |
$0.57
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.83
|
| Rate for Payer: Dignity Health Media |
$0.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.39
|
| Rate for Payer: Galaxy Health WC |
$0.83
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.78
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.83
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.49
|
| Rate for Payer: United Healthcare All Other HMO |
$0.49
|
| Rate for Payer: United Healthcare HMO Rider |
$0.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.83
|
| Rate for Payer: Vantage Medical Group Senior |
$0.83
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
OP
|
$0.48
|
|
|
Service Code
|
NDC 0378-4275-93
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.31
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.41
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.29
|
| Rate for Payer: BCBS Transplant Transplant |
$0.29
|
| Rate for Payer: Blue Shield of California Commercial |
$0.35
|
| Rate for Payer: Blue Shield of California EPN |
$0.28
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.34
|
| Rate for Payer: Cigna of CA PPO |
$0.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.41
|
| Rate for Payer: Dignity Health Media |
$0.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.19
|
| Rate for Payer: Galaxy Health WC |
$0.41
|
| Rate for Payer: Global Benefits Group Commercial |
$0.29
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Commercial |
$0.38
|
| Rate for Payer: Networks By Design Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$0.41
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.24
|
| Rate for Payer: United Healthcare All Other HMO |
$0.24
|
| Rate for Payer: United Healthcare HMO Rider |
$0.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.41
|
| Rate for Payer: Vantage Medical Group Senior |
$0.41
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
OP
|
$0.98
|
|
|
Service Code
|
NDC 31722-704-30
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.54
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.58
|
| Rate for Payer: BCBS Transplant Transplant |
$0.59
|
| Rate for Payer: Blue Shield of California Commercial |
$0.72
|
| Rate for Payer: Blue Shield of California EPN |
$0.57
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.83
|
| Rate for Payer: Dignity Health Media |
$0.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.39
|
| Rate for Payer: Galaxy Health WC |
$0.83
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.78
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.83
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.49
|
| Rate for Payer: United Healthcare All Other HMO |
$0.49
|
| Rate for Payer: United Healthcare HMO Rider |
$0.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.83
|
| Rate for Payer: Vantage Medical Group Senior |
$0.83
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
IP
|
$0.98
|
|
|
Service Code
|
NDC 63304-904-30
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Blue Shield of California Commercial |
$0.70
|
| Rate for Payer: Blue Shield of California EPN |
$0.50
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.39
|
| Rate for Payer: Galaxy Health WC |
$0.83
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.78
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.83
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
IP
|
$0.47
|
|
|
Service Code
|
NDC 0378-4275-77
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.40 |
| Rate for Payer: Blue Shield of California Commercial |
$0.33
|
| Rate for Payer: Blue Shield of California EPN |
$0.24
|
| Rate for Payer: Cash Price |
$0.21
|
| Rate for Payer: Cigna of CA HMO |
$0.33
|
| Rate for Payer: Cigna of CA PPO |
$0.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.19
|
| Rate for Payer: Galaxy Health WC |
$0.40
|
| Rate for Payer: Global Benefits Group Commercial |
$0.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: Multiplan Commercial |
$0.38
|
| Rate for Payer: Networks By Design Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$0.40
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
IP
|
$0.98
|
|
|
Service Code
|
NDC 31722-704-30
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Blue Shield of California Commercial |
$0.70
|
| Rate for Payer: Blue Shield of California EPN |
$0.50
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.39
|
| Rate for Payer: Galaxy Health WC |
$0.83
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.78
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.83
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
OP
|
$3.84
|
|
|
Service Code
|
NDC 68084-215-11
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.92 |
| Max. Negotiated Rate |
$3.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.52
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.26
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.29
|
| Rate for Payer: BCBS Transplant Transplant |
$2.30
|
| Rate for Payer: Blue Shield of California Commercial |
$2.83
|
| Rate for Payer: Blue Shield of California EPN |
$2.24
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cigna of CA HMO |
$2.69
|
| Rate for Payer: Cigna of CA PPO |
$2.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.26
|
| Rate for Payer: Dignity Health Media |
$3.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.26
|
| Rate for Payer: Global Benefits Group Commercial |
$2.30
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.56
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.92
|
| Rate for Payer: Multiplan Commercial |
$3.07
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.26
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.26
|
| Rate for Payer: Vantage Medical Group Senior |
$3.26
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
IP
|
$0.98
|
|
|
Service Code
|
NDC 31722-704-90
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: Blue Shield of California Commercial |
$0.70
|
| Rate for Payer: Blue Shield of California EPN |
$0.50
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.39
|
| Rate for Payer: Galaxy Health WC |
$0.83
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.78
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.83
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
IP
|
$0.48
|
|
|
Service Code
|
NDC 0378-4275-93
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.41 |
| Rate for Payer: Blue Shield of California Commercial |
$0.34
|
| Rate for Payer: Blue Shield of California EPN |
$0.25
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.34
|
| Rate for Payer: Cigna of CA PPO |
$0.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.19
|
| Rate for Payer: Galaxy Health WC |
$0.41
|
| Rate for Payer: Global Benefits Group Commercial |
$0.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Commercial |
$0.38
|
| Rate for Payer: Networks By Design Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$0.41
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
OP
|
$0.98
|
|
|
Service Code
|
NDC 31722-704-90
|
| Hospital Charge Code |
1710891
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$0.83 |
| Rate for Payer: BCBS Transplant Transplant |
$0.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.83
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.54
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.58
|
| Rate for Payer: Blue Shield of California Commercial |
$0.72
|
| Rate for Payer: Blue Shield of California EPN |
$0.57
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.83
|
| Rate for Payer: Dignity Health Media |
$0.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.39
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.39
|
| Rate for Payer: Galaxy Health WC |
$0.83
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.78
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.83
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.49
|
| Rate for Payer: United Healthcare All Other HMO |
$0.49
|
| Rate for Payer: United Healthcare HMO Rider |
$0.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.83
|
| Rate for Payer: Vantage Medical Group Senior |
$0.83
|
|
|
VALACYCLOVIR ORAL SUSPENSION COMPOUND 50 MG/ML [4080355]
|
Facility
IP
|
$0.72
|
|
|
Service Code
|
NDC 9994-0803-55
|
| Hospital Charge Code |
1715245
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.61 |
| Rate for Payer: Blue Shield of California Commercial |
$0.51
|
| Rate for Payer: Blue Shield of California EPN |
$0.37
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.29
|
| Rate for Payer: Galaxy Health WC |
$0.61
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.58
|
| Rate for Payer: Networks By Design Commercial |
$0.47
|
| Rate for Payer: Prime Health Services Commercial |
$0.61
|
|
|
VALACYCLOVIR ORAL SUSPENSION COMPOUND 50 MG/ML [4080355]
|
Facility
OP
|
$0.72
|
|
|
Service Code
|
NDC 9994-0803-55
|
| Hospital Charge Code |
1715245
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.61 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.61
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.43
|
| Rate for Payer: BCBS Transplant Transplant |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.53
|
| Rate for Payer: Blue Shield of California EPN |
$0.42
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.61
|
| Rate for Payer: Dignity Health Media |
$0.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.29
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.29
|
| Rate for Payer: Galaxy Health WC |
$0.61
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.58
|
| Rate for Payer: Networks By Design Commercial |
$0.47
|
| Rate for Payer: Prime Health Services Commercial |
$0.61
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.36
|
| Rate for Payer: United Healthcare All Other HMO |
$0.36
|
| Rate for Payer: United Healthcare HMO Rider |
$0.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.61
|
| Rate for Payer: Vantage Medical Group Senior |
$0.61
|
|
|
VALGANCICLOVIR 450 MG TABLET [30148]
|
Facility
IP
|
$51.00
|
|
|
Service Code
|
NDC 68084-965-95
|
| Hospital Charge Code |
1712248
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$43.35 |
| Rate for Payer: Blue Shield of California Commercial |
$36.31
|
| Rate for Payer: Blue Shield of California EPN |
$26.11
|
| Rate for Payer: Cash Price |
$22.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.40
|
| Rate for Payer: Galaxy Health WC |
$43.35
|
| Rate for Payer: Global Benefits Group Commercial |
$30.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.24
|
| Rate for Payer: Multiplan Commercial |
$40.80
|
| Rate for Payer: Networks By Design Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Commercial |
$43.35
|
|
|
VALGANCICLOVIR 450 MG TABLET [30148]
|
Facility
OP
|
$106.08
|
|
|
Service Code
|
NDC 0004-0038-22
|
| Hospital Charge Code |
1712248
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$25.46 |
| Max. Negotiated Rate |
$90.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$69.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$90.17
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$58.34
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$58.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.20
|
| Rate for Payer: BCBS Transplant Transplant |
$63.65
|
| Rate for Payer: Blue Shield of California Commercial |
$78.18
|
| Rate for Payer: Blue Shield of California EPN |
$61.95
|
| Rate for Payer: Cash Price |
$47.74
|
| Rate for Payer: Cash Price |
$47.74
|
| Rate for Payer: Cigna of CA HMO |
$67.89
|
| Rate for Payer: Cigna of CA PPO |
$78.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$90.17
|
| Rate for Payer: Dignity Health Media |
$90.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$90.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.43
|
| Rate for Payer: EPIC Health Plan Transplant |
$42.43
|
| Rate for Payer: Galaxy Health WC |
$90.17
|
| Rate for Payer: Global Benefits Group Commercial |
$63.65
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$79.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.46
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: Networks By Design Commercial |
$68.95
|
| Rate for Payer: Prime Health Services Commercial |
$90.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$63.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$63.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$53.04
|
| Rate for Payer: United Healthcare All Other HMO |
$53.04
|
| Rate for Payer: United Healthcare HMO Rider |
$53.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$53.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$90.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$90.17
|
| Rate for Payer: Vantage Medical Group Senior |
$90.17
|
|
|
VALGANCICLOVIR 450 MG TABLET [30148]
|
Facility
IP
|
$4.76
|
|
|
Service Code
|
NDC 65862-753-60
|
| Hospital Charge Code |
1712248
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.14 |
| Max. Negotiated Rate |
$4.05 |
| Rate for Payer: Blue Shield of California Commercial |
$3.39
|
| Rate for Payer: Blue Shield of California EPN |
$2.44
|
| Rate for Payer: Cash Price |
$2.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.90
|
| Rate for Payer: Galaxy Health WC |
$4.05
|
| Rate for Payer: Global Benefits Group Commercial |
$2.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.14
|
| Rate for Payer: Multiplan Commercial |
$3.81
|
| Rate for Payer: Networks By Design Commercial |
$3.09
|
| Rate for Payer: Prime Health Services Commercial |
$4.05
|
|
|
VALGANCICLOVIR 450 MG TABLET [30148]
|
Facility
IP
|
$20.19
|
|
|
Service Code
|
NDC 0603-6330-20
|
| Hospital Charge Code |
1712248
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$4.85 |
| Max. Negotiated Rate |
$17.16 |
| Rate for Payer: Blue Shield of California Commercial |
$14.38
|
| Rate for Payer: Blue Shield of California EPN |
$10.34
|
| Rate for Payer: Cash Price |
$9.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.08
|
| Rate for Payer: Galaxy Health WC |
$17.16
|
| Rate for Payer: Global Benefits Group Commercial |
$12.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$13.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.85
|
| Rate for Payer: Multiplan Commercial |
$16.15
|
| Rate for Payer: Networks By Design Commercial |
$13.12
|
| Rate for Payer: Prime Health Services Commercial |
$17.16
|
|
|
VALGANCICLOVIR 450 MG TABLET [30148]
|
Facility
IP
|
$51.00
|
|
|
Service Code
|
NDC 68084-965-25
|
| Hospital Charge Code |
1712248
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$43.35 |
| Rate for Payer: Blue Shield of California Commercial |
$36.31
|
| Rate for Payer: Blue Shield of California EPN |
$26.11
|
| Rate for Payer: Cash Price |
$22.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.40
|
| Rate for Payer: Galaxy Health WC |
$43.35
|
| Rate for Payer: Global Benefits Group Commercial |
$30.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.24
|
| Rate for Payer: Multiplan Commercial |
$40.80
|
| Rate for Payer: Networks By Design Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Commercial |
$43.35
|
|
|
VALGANCICLOVIR 450 MG TABLET [30148]
|
Facility
OP
|
$6.00
|
|
|
Service Code
|
NDC 31722-832-60
|
| Hospital Charge Code |
1712248
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$5.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.94
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.57
|
| Rate for Payer: BCBS Transplant Transplant |
$3.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4.42
|
| Rate for Payer: Blue Shield of California EPN |
$3.50
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cigna of CA HMO |
$3.84
|
| Rate for Payer: Cigna of CA PPO |
$4.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.10
|
| Rate for Payer: Dignity Health Media |
$5.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.40
|
| Rate for Payer: Galaxy Health WC |
$5.10
|
| Rate for Payer: Global Benefits Group Commercial |
$3.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.44
|
| Rate for Payer: Multiplan Commercial |
$4.80
|
| Rate for Payer: Networks By Design Commercial |
$3.90
|
| Rate for Payer: Prime Health Services Commercial |
$5.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.00
|
| Rate for Payer: United Healthcare All Other HMO |
$3.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.10
|
| Rate for Payer: Vantage Medical Group Senior |
$5.10
|
|
|
VALGANCICLOVIR 450 MG TABLET [30148]
|
Facility
IP
|
$5.00
|
|
|
Service Code
|
NDC 27241-158-60
|
| Hospital Charge Code |
1712248
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$4.25 |
| Rate for Payer: Blue Shield of California Commercial |
$3.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Cash Price |
$2.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.00
|
| Rate for Payer: Galaxy Health WC |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$3.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.20
|
| Rate for Payer: Multiplan Commercial |
$4.00
|
| Rate for Payer: Networks By Design Commercial |
$3.25
|
| Rate for Payer: Prime Health Services Commercial |
$4.25
|
|
|
VALGANCICLOVIR 450 MG TABLET [30148]
|
Facility
OP
|
$51.00
|
|
|
Service Code
|
NDC 68084-965-25
|
| Hospital Charge Code |
1712248
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$12.24 |
| Max. Negotiated Rate |
$43.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$43.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$28.05
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$28.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$30.39
|
| Rate for Payer: BCBS Transplant Transplant |
$30.60
|
| Rate for Payer: Blue Shield of California Commercial |
$37.59
|
| Rate for Payer: Blue Shield of California EPN |
$29.78
|
| Rate for Payer: Cash Price |
$22.95
|
| Rate for Payer: Cash Price |
$22.95
|
| Rate for Payer: Cigna of CA HMO |
$32.64
|
| Rate for Payer: Cigna of CA PPO |
$37.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$43.35
|
| Rate for Payer: Dignity Health Media |
$43.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$43.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$20.40
|
| Rate for Payer: Galaxy Health WC |
$43.35
|
| Rate for Payer: Global Benefits Group Commercial |
$30.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$38.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$34.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$19.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.24
|
| Rate for Payer: Multiplan Commercial |
$40.80
|
| Rate for Payer: Networks By Design Commercial |
$33.15
|
| Rate for Payer: Prime Health Services Commercial |
$43.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$25.50
|
| Rate for Payer: United Healthcare All Other HMO |
$25.50
|
| Rate for Payer: United Healthcare HMO Rider |
$25.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$25.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$43.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$43.35
|
| Rate for Payer: Vantage Medical Group Senior |
$43.35
|
|
|
VALGANCICLOVIR 450 MG TABLET [30148]
|
Facility
IP
|
$106.08
|
|
|
Service Code
|
NDC 0004-0038-22
|
| Hospital Charge Code |
1712248
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$25.46 |
| Max. Negotiated Rate |
$90.17 |
| Rate for Payer: Blue Shield of California Commercial |
$75.53
|
| Rate for Payer: Blue Shield of California EPN |
$54.31
|
| Rate for Payer: Cash Price |
$47.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.43
|
| Rate for Payer: Galaxy Health WC |
$90.17
|
| Rate for Payer: Global Benefits Group Commercial |
$63.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$70.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$40.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.46
|
| Rate for Payer: Multiplan Commercial |
$84.86
|
| Rate for Payer: Networks By Design Commercial |
$68.95
|
| Rate for Payer: Prime Health Services Commercial |
$90.17
|
|
|
VALGANCICLOVIR 450 MG TABLET [30148]
|
Facility
OP
|
$28.11
|
|
|
Service Code
|
NDC 55111-762-60
|
| Hospital Charge Code |
1712248
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.75 |
| Max. Negotiated Rate |
$23.89 |
| Rate for Payer: Galaxy Health WC |
$23.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23.89
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.46
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$15.46
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.75
|
| Rate for Payer: BCBS Transplant Transplant |
$16.87
|
| Rate for Payer: Blue Shield of California Commercial |
$20.72
|
| Rate for Payer: Blue Shield of California EPN |
$16.42
|
| Rate for Payer: Cash Price |
$12.65
|
| Rate for Payer: Cash Price |
$12.65
|
| Rate for Payer: Cigna of CA HMO |
$17.99
|
| Rate for Payer: Cigna of CA PPO |
$20.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.89
|
| Rate for Payer: Dignity Health Media |
$23.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.24
|
| Rate for Payer: Global Benefits Group Commercial |
$16.87
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.75
|
| Rate for Payer: Multiplan Commercial |
$22.49
|
| Rate for Payer: Networks By Design Commercial |
$18.27
|
| Rate for Payer: Prime Health Services Commercial |
$23.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.06
|
| Rate for Payer: United Healthcare All Other HMO |
$14.06
|
| Rate for Payer: United Healthcare HMO Rider |
$14.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.89
|
| Rate for Payer: Vantage Medical Group Senior |
$23.89
|
|
