|
IRON DEXTRAN 50 MG/ML INJECTION SOLUTION [221652]
|
Facility
|
IP
|
$22.37
|
|
|
Service Code
|
HCPCS J1750
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.47 |
| Max. Negotiated Rate |
$19.01 |
| Rate for Payer: Adventist Health Commercial |
$4.47
|
| Rate for Payer: Blue Shield of California Commercial |
$16.51
|
| Rate for Payer: Blue Shield of California EPN |
$10.87
|
| Rate for Payer: Cash Price |
$12.30
|
| Rate for Payer: Cigna of CA HMO |
$15.66
|
| Rate for Payer: Cigna of CA PPO |
$15.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.95
|
| Rate for Payer: EPIC Health Plan Senior |
$8.95
|
| Rate for Payer: Galaxy Health WC |
$19.01
|
| Rate for Payer: Global Benefits Group Commercial |
$13.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$14.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$13.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.37
|
| Rate for Payer: Multiplan Commercial |
$17.90
|
| Rate for Payer: Networks By Design Commercial |
$11.19
|
| Rate for Payer: Prime Health Services Commercial |
$19.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.40
|
| Rate for Payer: United Healthcare All Other HMO |
$8.17
|
| Rate for Payer: United Healthcare HMO Rider |
$8.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.33
|
|
|
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION [29132]
|
Facility
|
IP
|
$7.06
|
|
|
Service Code
|
HCPCS J1756
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.41 |
| Max. Negotiated Rate |
$6.00 |
| Rate for Payer: Adventist Health Commercial |
$1.41
|
| Rate for Payer: Adventist Health Commercial |
$3.12
|
| Rate for Payer: Blue Shield of California Commercial |
$5.21
|
| Rate for Payer: Blue Shield of California Commercial |
$11.51
|
| Rate for Payer: Blue Shield of California EPN |
$7.58
|
| Rate for Payer: Blue Shield of California EPN |
$3.43
|
| Rate for Payer: Cash Price |
$3.88
|
| Rate for Payer: Cash Price |
$8.57
|
| Rate for Payer: Cigna of CA HMO |
$4.94
|
| Rate for Payer: Cigna of CA HMO |
$10.91
|
| Rate for Payer: Cigna of CA PPO |
$10.91
|
| Rate for Payer: Cigna of CA PPO |
$4.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.82
|
| Rate for Payer: EPIC Health Plan Senior |
$6.24
|
| Rate for Payer: EPIC Health Plan Senior |
$2.82
|
| Rate for Payer: Galaxy Health WC |
$13.25
|
| Rate for Payer: Galaxy Health WC |
$6.00
|
| Rate for Payer: Global Benefits Group Commercial |
$9.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.69
|
| Rate for Payer: Multiplan Commercial |
$12.47
|
| Rate for Payer: Multiplan Commercial |
$5.65
|
| Rate for Payer: Networks By Design Commercial |
$3.53
|
| Rate for Payer: Networks By Design Commercial |
$7.79
|
| Rate for Payer: Prime Health Services Commercial |
$6.00
|
| Rate for Payer: Prime Health Services Commercial |
$13.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.65
|
| Rate for Payer: United Healthcare All Other HMO |
$2.58
|
| Rate for Payer: United Healthcare All Other HMO |
$5.70
|
| Rate for Payer: United Healthcare HMO Rider |
$5.57
|
| Rate for Payer: United Healthcare HMO Rider |
$2.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.31
|
|
|
IRON SUCROSE 100 MG IRON/5 ML INTRAVENOUS SOLUTION [29132]
|
Facility
|
OP
|
$15.59
|
|
|
Service Code
|
HCPCS J1756
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$13.25 |
| Rate for Payer: Adventist Health Commercial |
$3.12
|
| Rate for Payer: Adventist Health Commercial |
$1.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.38
|
| Rate for Payer: Blue Shield of California Commercial |
$0.61
|
| Rate for Payer: Blue Shield of California Commercial |
$0.61
|
| Rate for Payer: Blue Shield of California EPN |
$0.61
|
| Rate for Payer: Blue Shield of California EPN |
$0.61
|
| Rate for Payer: Cash Price |
$8.57
|
| Rate for Payer: Cash Price |
$3.88
|
| Rate for Payer: Cash Price |
$8.57
|
| Rate for Payer: Cash Price |
$3.88
|
| Rate for Payer: Cigna of CA HMO |
$4.94
|
| Rate for Payer: Cigna of CA HMO |
$10.91
|
| Rate for Payer: Cigna of CA PPO |
$10.91
|
| Rate for Payer: Cigna of CA PPO |
$4.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.82
|
| Rate for Payer: EPIC Health Plan Senior |
$2.82
|
| Rate for Payer: EPIC Health Plan Senior |
$6.24
|
| Rate for Payer: Galaxy Health WC |
$6.00
|
| Rate for Payer: Galaxy Health WC |
$13.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4.24
|
| Rate for Payer: Global Benefits Group Commercial |
$9.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.94
|
| Rate for Payer: Multiplan Commercial |
$5.65
|
| Rate for Payer: Multiplan Commercial |
$12.47
|
| Rate for Payer: Networks By Design Commercial |
$3.53
|
| Rate for Payer: Networks By Design Commercial |
$7.79
|
| Rate for Payer: Prime Health Services Commercial |
$13.25
|
| Rate for Payer: Prime Health Services Commercial |
$6.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.65
|
| Rate for Payer: United Healthcare All Other HMO |
$5.70
|
| Rate for Payer: United Healthcare All Other HMO |
$2.58
|
| Rate for Payer: United Healthcare HMO Rider |
$2.52
|
| Rate for Payer: United Healthcare HMO Rider |
$5.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.31
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.00
|
| Rate for Payer: Vantage Medical Group Senior |
$13.25
|
| Rate for Payer: Vantage Medical Group Senior |
$6.00
|
|
|
IRON SUCROSE 200 MG IRON/10 ML INTRAVENOUS SOLUTION [187493]
|
Facility
|
IP
|
$15.59
|
|
|
Service Code
|
HCPCS J1756
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$13.25 |
| Rate for Payer: Adventist Health Commercial |
$3.12
|
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Blue Shield of California Commercial |
$11.51
|
| Rate for Payer: Blue Shield of California Commercial |
$10.84
|
| Rate for Payer: Blue Shield of California EPN |
$7.14
|
| Rate for Payer: Blue Shield of California EPN |
$7.58
|
| Rate for Payer: Cash Price |
$8.57
|
| Rate for Payer: Cash Price |
$8.08
|
| Rate for Payer: Cigna of CA HMO |
$10.91
|
| Rate for Payer: Cigna of CA HMO |
$10.28
|
| Rate for Payer: Cigna of CA PPO |
$10.28
|
| Rate for Payer: Cigna of CA PPO |
$10.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5.88
|
| Rate for Payer: EPIC Health Plan Senior |
$6.24
|
| Rate for Payer: Galaxy Health WC |
$12.49
|
| Rate for Payer: Galaxy Health WC |
$13.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Global Benefits Group Commercial |
$9.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.74
|
| Rate for Payer: Multiplan Commercial |
$11.75
|
| Rate for Payer: Multiplan Commercial |
$12.47
|
| Rate for Payer: Networks By Design Commercial |
$7.79
|
| Rate for Payer: Networks By Design Commercial |
$7.34
|
| Rate for Payer: Prime Health Services Commercial |
$13.25
|
| Rate for Payer: Prime Health Services Commercial |
$12.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.85
|
| Rate for Payer: United Healthcare All Other HMO |
$5.70
|
| Rate for Payer: United Healthcare All Other HMO |
$5.37
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.11
|
|
|
IRON SUCROSE 200 MG IRON/10 ML INTRAVENOUS SOLUTION [187493]
|
Facility
|
OP
|
$14.69
|
|
|
Service Code
|
HCPCS J1756
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$12.49 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Adventist Health Commercial |
$3.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.38
|
| Rate for Payer: Blue Shield of California Commercial |
$0.61
|
| Rate for Payer: Blue Shield of California Commercial |
$0.61
|
| Rate for Payer: Blue Shield of California EPN |
$0.61
|
| Rate for Payer: Blue Shield of California EPN |
$0.61
|
| Rate for Payer: Cash Price |
$8.08
|
| Rate for Payer: Cash Price |
$8.57
|
| Rate for Payer: Cash Price |
$8.08
|
| Rate for Payer: Cash Price |
$8.57
|
| Rate for Payer: Cigna of CA HMO |
$10.91
|
| Rate for Payer: Cigna of CA HMO |
$10.28
|
| Rate for Payer: Cigna of CA PPO |
$10.28
|
| Rate for Payer: Cigna of CA PPO |
$10.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.24
|
| Rate for Payer: EPIC Health Plan Senior |
$6.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5.88
|
| Rate for Payer: Galaxy Health WC |
$13.25
|
| Rate for Payer: Galaxy Health WC |
$12.49
|
| Rate for Payer: Global Benefits Group Commercial |
$9.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.91
|
| Rate for Payer: Multiplan Commercial |
$12.47
|
| Rate for Payer: Multiplan Commercial |
$11.75
|
| Rate for Payer: Networks By Design Commercial |
$7.79
|
| Rate for Payer: Networks By Design Commercial |
$7.34
|
| Rate for Payer: Prime Health Services Commercial |
$12.49
|
| Rate for Payer: Prime Health Services Commercial |
$13.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.85
|
| Rate for Payer: United Healthcare All Other HMO |
$5.37
|
| Rate for Payer: United Healthcare All Other HMO |
$5.70
|
| Rate for Payer: United Healthcare HMO Rider |
$5.57
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.25
|
| Rate for Payer: Vantage Medical Group Senior |
$12.49
|
| Rate for Payer: Vantage Medical Group Senior |
$13.25
|
|
|
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION [121793]
|
Facility
|
IP
|
$15.59
|
|
|
Service Code
|
HCPCS J1756
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.12 |
| Max. Negotiated Rate |
$13.25 |
| Rate for Payer: Blue Shield of California EPN |
$7.58
|
| Rate for Payer: Adventist Health Commercial |
$3.12
|
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Blue Shield of California Commercial |
$11.51
|
| Rate for Payer: Blue Shield of California Commercial |
$10.84
|
| Rate for Payer: Blue Shield of California EPN |
$7.14
|
| Rate for Payer: Cash Price |
$8.57
|
| Rate for Payer: Cash Price |
$8.08
|
| Rate for Payer: Cigna of CA HMO |
$10.91
|
| Rate for Payer: Cigna of CA HMO |
$10.28
|
| Rate for Payer: Cigna of CA PPO |
$10.28
|
| Rate for Payer: Cigna of CA PPO |
$10.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5.88
|
| Rate for Payer: EPIC Health Plan Senior |
$6.24
|
| Rate for Payer: Galaxy Health WC |
$12.49
|
| Rate for Payer: Galaxy Health WC |
$13.25
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Global Benefits Group Commercial |
$9.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.74
|
| Rate for Payer: Multiplan Commercial |
$11.75
|
| Rate for Payer: Multiplan Commercial |
$12.47
|
| Rate for Payer: Networks By Design Commercial |
$7.79
|
| Rate for Payer: Networks By Design Commercial |
$7.34
|
| Rate for Payer: Prime Health Services Commercial |
$13.25
|
| Rate for Payer: Prime Health Services Commercial |
$12.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.85
|
| Rate for Payer: United Healthcare All Other HMO |
$5.70
|
| Rate for Payer: United Healthcare All Other HMO |
$5.37
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare HMO Rider |
$5.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.11
|
|
|
IRON SUCROSE 50 MG IRON/2.5 ML INTRAVENOUS SOLUTION [121793]
|
Facility
|
OP
|
$14.69
|
|
|
Service Code
|
HCPCS J1756
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$12.49 |
| Rate for Payer: Adventist Health Commercial |
$2.94
|
| Rate for Payer: Adventist Health Commercial |
$3.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.38
|
| Rate for Payer: Blue Shield of California Commercial |
$0.61
|
| Rate for Payer: Blue Shield of California Commercial |
$0.61
|
| Rate for Payer: Blue Shield of California EPN |
$0.61
|
| Rate for Payer: Blue Shield of California EPN |
$0.61
|
| Rate for Payer: Cash Price |
$8.08
|
| Rate for Payer: Cash Price |
$8.57
|
| Rate for Payer: Cash Price |
$8.08
|
| Rate for Payer: Cash Price |
$8.57
|
| Rate for Payer: Cigna of CA HMO |
$10.91
|
| Rate for Payer: Cigna of CA HMO |
$10.28
|
| Rate for Payer: Cigna of CA PPO |
$10.28
|
| Rate for Payer: Cigna of CA PPO |
$10.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.24
|
| Rate for Payer: EPIC Health Plan Senior |
$6.24
|
| Rate for Payer: EPIC Health Plan Senior |
$5.88
|
| Rate for Payer: Galaxy Health WC |
$13.25
|
| Rate for Payer: Galaxy Health WC |
$12.49
|
| Rate for Payer: Global Benefits Group Commercial |
$9.35
|
| Rate for Payer: Global Benefits Group Commercial |
$8.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.44
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.91
|
| Rate for Payer: Multiplan Commercial |
$12.47
|
| Rate for Payer: Multiplan Commercial |
$11.75
|
| Rate for Payer: Networks By Design Commercial |
$7.79
|
| Rate for Payer: Networks By Design Commercial |
$7.34
|
| Rate for Payer: Prime Health Services Commercial |
$12.49
|
| Rate for Payer: Prime Health Services Commercial |
$13.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.85
|
| Rate for Payer: United Healthcare All Other HMO |
$5.37
|
| Rate for Payer: United Healthcare All Other HMO |
$5.70
|
| Rate for Payer: United Healthcare HMO Rider |
$5.57
|
| Rate for Payer: United Healthcare HMO Rider |
$5.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.81
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.25
|
| Rate for Payer: Vantage Medical Group Senior |
$12.49
|
| Rate for Payer: Vantage Medical Group Senior |
$13.25
|
|
|
ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION [227445]
|
Facility
|
OP
|
$208.78
|
|
|
Service Code
|
HCPCS J9227
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.76 |
| Max. Negotiated Rate |
$228.97 |
| Rate for Payer: Adventist Health Commercial |
$41.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$136.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$124.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$91.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$82.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$228.97
|
| Rate for Payer: Blue Shield of California Commercial |
$94.98
|
| Rate for Payer: Blue Shield of California EPN |
$94.98
|
| Rate for Payer: Cash Price |
$114.83
|
| Rate for Payer: Cash Price |
$114.83
|
| Rate for Payer: Cigna of CA HMO |
$146.15
|
| Rate for Payer: Cigna of CA PPO |
$146.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$103.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$91.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$91.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.86
|
| Rate for Payer: EPIC Health Plan Senior |
$82.86
|
| Rate for Payer: Galaxy Health WC |
$177.46
|
| Rate for Payer: Global Benefits Group Commercial |
$125.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$135.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$78.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$82.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$139.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$150.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$104.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$111.03
|
| Rate for Payer: Multiplan Commercial |
$167.02
|
| Rate for Payer: Networks By Design Commercial |
$104.39
|
| Rate for Payer: Prime Health Services Commercial |
$177.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$125.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$125.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$78.36
|
| Rate for Payer: United Healthcare All Other HMO |
$76.27
|
| Rate for Payer: United Healthcare HMO Rider |
$74.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.38
|
| Rate for Payer: Upland Medical Group Pediatric |
$82.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$103.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$91.15
|
| Rate for Payer: Vantage Medical Group Senior |
$91.15
|
|
|
ISATUXIMAB-IRFC 20 MG/ML INTRAVENOUS SOLUTION [227445]
|
Facility
|
IP
|
$208.78
|
|
|
Service Code
|
HCPCS J9227
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$41.76 |
| Max. Negotiated Rate |
$177.46 |
| Rate for Payer: Adventist Health Commercial |
$41.76
|
| Rate for Payer: Blue Shield of California Commercial |
$154.08
|
| Rate for Payer: Blue Shield of California EPN |
$101.47
|
| Rate for Payer: Cash Price |
$114.83
|
| Rate for Payer: Cigna of CA HMO |
$146.15
|
| Rate for Payer: Cigna of CA PPO |
$146.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.51
|
| Rate for Payer: EPIC Health Plan Senior |
$83.51
|
| Rate for Payer: Galaxy Health WC |
$177.46
|
| Rate for Payer: Global Benefits Group Commercial |
$125.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$139.26
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$79.55
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$129.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$50.11
|
| Rate for Payer: Multiplan Commercial |
$167.02
|
| Rate for Payer: Networks By Design Commercial |
$104.39
|
| Rate for Payer: Prime Health Services Commercial |
$177.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$78.36
|
| Rate for Payer: United Healthcare All Other HMO |
$76.27
|
| Rate for Payer: United Healthcare HMO Rider |
$74.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.38
|
|
|
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE [209331]
|
Facility
|
OP
|
$138.90
|
|
|
Service Code
|
NDC 0469-0520-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$27.78 |
| Max. Negotiated Rate |
$118.06 |
| Rate for Payer: Adventist Health Commercial |
$27.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$118.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$76.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$104.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.30
|
| Rate for Payer: Cash Price |
$76.39
|
| Rate for Payer: Cigna of CA HMO |
$97.23
|
| Rate for Payer: Cigna of CA PPO |
$97.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$118.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$118.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$118.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.56
|
| Rate for Payer: EPIC Health Plan Senior |
$55.56
|
| Rate for Payer: Galaxy Health WC |
$118.06
|
| Rate for Payer: Global Benefits Group Commercial |
$83.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$97.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$97.23
|
| Rate for Payer: Multiplan Commercial |
$111.12
|
| Rate for Payer: Networks By Design Commercial |
$90.28
|
| Rate for Payer: Prime Health Services Commercial |
$118.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$83.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$83.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.45
|
| Rate for Payer: United Healthcare All Other HMO |
$69.45
|
| Rate for Payer: United Healthcare HMO Rider |
$69.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$118.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$118.06
|
| Rate for Payer: Vantage Medical Group Senior |
$118.06
|
|
|
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE [209331]
|
Facility
|
OP
|
$138.90
|
|
|
Service Code
|
NDC 0469-0520-02
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$27.78 |
| Max. Negotiated Rate |
$118.06 |
| Rate for Payer: Adventist Health Commercial |
$27.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$118.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$76.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$104.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$85.30
|
| Rate for Payer: Cash Price |
$76.39
|
| Rate for Payer: Cigna of CA HMO |
$97.23
|
| Rate for Payer: Cigna of CA PPO |
$97.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$118.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$118.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$118.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.56
|
| Rate for Payer: EPIC Health Plan Senior |
$55.56
|
| Rate for Payer: Galaxy Health WC |
$118.06
|
| Rate for Payer: Global Benefits Group Commercial |
$83.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$97.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$97.23
|
| Rate for Payer: Multiplan Commercial |
$111.12
|
| Rate for Payer: Networks By Design Commercial |
$90.28
|
| Rate for Payer: Prime Health Services Commercial |
$118.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$83.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$83.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$69.45
|
| Rate for Payer: United Healthcare All Other HMO |
$69.45
|
| Rate for Payer: United Healthcare HMO Rider |
$69.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$69.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$118.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$118.06
|
| Rate for Payer: Vantage Medical Group Senior |
$118.06
|
|
|
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE [209331]
|
Facility
|
IP
|
$138.90
|
|
|
Service Code
|
NDC 0469-0520-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$27.78 |
| Max. Negotiated Rate |
$118.06 |
| Rate for Payer: Adventist Health Commercial |
$27.78
|
| Rate for Payer: Blue Shield of California Commercial |
$102.51
|
| Rate for Payer: Blue Shield of California EPN |
$67.51
|
| Rate for Payer: Cash Price |
$76.39
|
| Rate for Payer: Cigna of CA HMO |
$97.23
|
| Rate for Payer: Cigna of CA PPO |
$97.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.56
|
| Rate for Payer: EPIC Health Plan Senior |
$55.56
|
| Rate for Payer: Galaxy Health WC |
$118.06
|
| Rate for Payer: Global Benefits Group Commercial |
$83.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.34
|
| Rate for Payer: Multiplan Commercial |
$111.12
|
| Rate for Payer: Networks By Design Commercial |
$90.28
|
| Rate for Payer: Prime Health Services Commercial |
$118.06
|
|
|
ISAVUCONAZONIUM SULFATE 186 MG CAPSULE [209331]
|
Facility
|
IP
|
$138.90
|
|
|
Service Code
|
NDC 0469-0520-02
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$27.78 |
| Max. Negotiated Rate |
$118.06 |
| Rate for Payer: Adventist Health Commercial |
$27.78
|
| Rate for Payer: Blue Shield of California Commercial |
$102.51
|
| Rate for Payer: Blue Shield of California EPN |
$67.51
|
| Rate for Payer: Cash Price |
$76.39
|
| Rate for Payer: Cigna of CA HMO |
$97.23
|
| Rate for Payer: Cigna of CA PPO |
$97.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$55.56
|
| Rate for Payer: EPIC Health Plan Senior |
$55.56
|
| Rate for Payer: Galaxy Health WC |
$118.06
|
| Rate for Payer: Global Benefits Group Commercial |
$83.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$92.65
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$52.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$85.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.34
|
| Rate for Payer: Multiplan Commercial |
$111.12
|
| Rate for Payer: Networks By Design Commercial |
$90.28
|
| Rate for Payer: Prime Health Services Commercial |
$118.06
|
|
|
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION [209328]
|
Facility
|
IP
|
$473.26
|
|
|
Service Code
|
HCPCS J1833
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$94.65 |
| Max. Negotiated Rate |
$402.27 |
| Rate for Payer: Adventist Health Commercial |
$94.65
|
| Rate for Payer: Blue Shield of California Commercial |
$349.27
|
| Rate for Payer: Blue Shield of California EPN |
$230.00
|
| Rate for Payer: Cash Price |
$260.29
|
| Rate for Payer: Cigna of CA HMO |
$331.28
|
| Rate for Payer: Cigna of CA PPO |
$331.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$189.30
|
| Rate for Payer: EPIC Health Plan Senior |
$189.30
|
| Rate for Payer: Galaxy Health WC |
$402.27
|
| Rate for Payer: Global Benefits Group Commercial |
$283.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$292.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.58
|
| Rate for Payer: Multiplan Commercial |
$378.61
|
| Rate for Payer: Networks By Design Commercial |
$236.63
|
| Rate for Payer: Prime Health Services Commercial |
$402.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$177.61
|
| Rate for Payer: United Healthcare All Other HMO |
$172.88
|
| Rate for Payer: United Healthcare HMO Rider |
$169.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$154.99
|
|
|
ISAVUCONAZONIUM SULFATE 372 MG INTRAVENOUS SOLUTION [209328]
|
Facility
|
OP
|
$473.26
|
|
|
Service Code
|
HCPCS J1833
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$402.27 |
| Rate for Payer: Adventist Health Commercial |
$94.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$310.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.87
|
| Rate for Payer: Blue Shield of California Commercial |
$1.24
|
| Rate for Payer: Blue Shield of California EPN |
$1.24
|
| Rate for Payer: Cash Price |
$260.29
|
| Rate for Payer: Cash Price |
$260.29
|
| Rate for Payer: Cigna of CA HMO |
$331.28
|
| Rate for Payer: Cigna of CA PPO |
$331.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.36
|
| Rate for Payer: EPIC Health Plan Senior |
$1.01
|
| Rate for Payer: Galaxy Health WC |
$402.27
|
| Rate for Payer: Global Benefits Group Commercial |
$283.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$315.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$180.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$113.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.35
|
| Rate for Payer: Multiplan Commercial |
$378.61
|
| Rate for Payer: Networks By Design Commercial |
$236.63
|
| Rate for Payer: Prime Health Services Commercial |
$402.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$283.96
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$283.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$177.61
|
| Rate for Payer: United Healthcare All Other HMO |
$172.88
|
| Rate for Payer: United Healthcare HMO Rider |
$169.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$154.99
|
| Rate for Payer: Upland Medical Group Pediatric |
$1.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.11
|
| Rate for Payer: Vantage Medical Group Senior |
$1.11
|
|
|
ISONIAZID 100 MG TABLET [4026]
|
Facility
|
IP
|
$2.14
|
|
|
Service Code
|
NDC 64950-216-10
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$1.82 |
| Rate for Payer: Adventist Health Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$1.58
|
| Rate for Payer: Blue Shield of California EPN |
$1.04
|
| Rate for Payer: Cash Price |
$1.17
|
| Rate for Payer: Cigna of CA HMO |
$1.50
|
| Rate for Payer: Cigna of CA PPO |
$1.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.86
|
| Rate for Payer: EPIC Health Plan Senior |
$0.86
|
| Rate for Payer: Galaxy Health WC |
$1.82
|
| Rate for Payer: Global Benefits Group Commercial |
$1.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.51
|
| Rate for Payer: Multiplan Commercial |
$1.71
|
| Rate for Payer: Networks By Design Commercial |
$1.39
|
| Rate for Payer: Prime Health Services Commercial |
$1.82
|
|
|
ISONIAZID 100 MG TABLET [4026]
|
Facility
|
OP
|
$0.14
|
|
|
Service Code
|
NDC 0555-0066-02
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.12 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.09
|
| Rate for Payer: Cash Price |
$0.08
|
| Rate for Payer: Cigna of CA HMO |
$0.10
|
| Rate for Payer: Cigna of CA PPO |
$0.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.06
|
| Rate for Payer: EPIC Health Plan Senior |
$0.06
|
| Rate for Payer: Galaxy Health WC |
$0.12
|
| Rate for Payer: Global Benefits Group Commercial |
$0.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.10
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
| Rate for Payer: Networks By Design Commercial |
$0.09
|
| Rate for Payer: Prime Health Services Commercial |
$0.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.07
|
| Rate for Payer: United Healthcare All Other HMO |
$0.07
|
| Rate for Payer: United Healthcare HMO Rider |
$0.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.12
|
| Rate for Payer: Vantage Medical Group Senior |
$0.12
|
|
|
ISONIAZID 100 MG TABLET [4026]
|
Facility
|
IP
|
$0.14
|
|
|
Service Code
|
NDC 0555-0066-02
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.12 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California EPN |
$0.07
|
| Rate for Payer: Cash Price |
$0.08
|
| Rate for Payer: Cigna of CA HMO |
$0.10
|
| Rate for Payer: Cigna of CA PPO |
$0.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.06
|
| Rate for Payer: EPIC Health Plan Senior |
$0.06
|
| Rate for Payer: Galaxy Health WC |
$0.12
|
| Rate for Payer: Global Benefits Group Commercial |
$0.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
| Rate for Payer: Networks By Design Commercial |
$0.09
|
| Rate for Payer: Prime Health Services Commercial |
$0.12
|
|
|
ISONIAZID 100 MG TABLET [4026]
|
Facility
|
OP
|
$2.14
|
|
|
Service Code
|
NDC 64950-216-10
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.43 |
| Max. Negotiated Rate |
$1.82 |
| Rate for Payer: Adventist Health Commercial |
$0.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.31
|
| Rate for Payer: Cash Price |
$1.17
|
| Rate for Payer: Cigna of CA HMO |
$1.50
|
| Rate for Payer: Cigna of CA PPO |
$1.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.86
|
| Rate for Payer: EPIC Health Plan Senior |
$0.86
|
| Rate for Payer: Galaxy Health WC |
$1.82
|
| Rate for Payer: Global Benefits Group Commercial |
$1.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.43
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.82
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.50
|
| Rate for Payer: Multiplan Commercial |
$1.71
|
| Rate for Payer: Networks By Design Commercial |
$1.39
|
| Rate for Payer: Prime Health Services Commercial |
$1.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.07
|
| Rate for Payer: United Healthcare All Other HMO |
$1.07
|
| Rate for Payer: United Healthcare HMO Rider |
$1.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.82
|
| Rate for Payer: Vantage Medical Group Senior |
$1.82
|
|
|
ISONIAZID 300 MG TABLET [4027]
|
Facility
|
IP
|
$4.20
|
|
|
Service Code
|
NDC 64950-217-03
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$3.57 |
| Rate for Payer: Adventist Health Commercial |
$0.84
|
| Rate for Payer: Blue Shield of California Commercial |
$3.10
|
| Rate for Payer: Blue Shield of California EPN |
$2.04
|
| Rate for Payer: Cash Price |
$2.31
|
| Rate for Payer: Cigna of CA HMO |
$2.94
|
| Rate for Payer: Cigna of CA PPO |
$2.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.68
|
| Rate for Payer: EPIC Health Plan Senior |
$1.68
|
| Rate for Payer: Galaxy Health WC |
$3.57
|
| Rate for Payer: Global Benefits Group Commercial |
$2.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.01
|
| Rate for Payer: Multiplan Commercial |
$3.36
|
| Rate for Payer: Networks By Design Commercial |
$2.73
|
| Rate for Payer: Prime Health Services Commercial |
$3.57
|
|
|
ISONIAZID 300 MG TABLET [4027]
|
Facility
|
OP
|
$4.20
|
|
|
Service Code
|
NDC 64950-217-03
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.84 |
| Max. Negotiated Rate |
$3.57 |
| Rate for Payer: Adventist Health Commercial |
$0.84
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.58
|
| Rate for Payer: Cash Price |
$2.31
|
| Rate for Payer: Cigna of CA HMO |
$2.94
|
| Rate for Payer: Cigna of CA PPO |
$2.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.68
|
| Rate for Payer: EPIC Health Plan Senior |
$1.68
|
| Rate for Payer: Galaxy Health WC |
$3.57
|
| Rate for Payer: Global Benefits Group Commercial |
$2.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.60
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.94
|
| Rate for Payer: Multiplan Commercial |
$3.36
|
| Rate for Payer: Networks By Design Commercial |
$2.73
|
| Rate for Payer: Prime Health Services Commercial |
$3.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.10
|
| Rate for Payer: United Healthcare All Other HMO |
$2.10
|
| Rate for Payer: United Healthcare HMO Rider |
$2.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.57
|
| Rate for Payer: Vantage Medical Group Senior |
$3.57
|
|
|
ISONIAZID 300 MG TABLET [4027]
|
Facility
|
OP
|
$3.50
|
|
|
Service Code
|
NDC 64950-217-10
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$2.98 |
| Rate for Payer: Adventist Health Commercial |
$0.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.98
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.15
|
| Rate for Payer: Cash Price |
$1.93
|
| Rate for Payer: Cigna of CA HMO |
$2.45
|
| Rate for Payer: Cigna of CA PPO |
$2.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.98
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1.40
|
| Rate for Payer: Galaxy Health WC |
$2.98
|
| Rate for Payer: Global Benefits Group Commercial |
$2.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.45
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.45
|
| Rate for Payer: Multiplan Commercial |
$2.80
|
| Rate for Payer: Networks By Design Commercial |
$2.27
|
| Rate for Payer: Prime Health Services Commercial |
$2.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.75
|
| Rate for Payer: United Healthcare All Other HMO |
$1.75
|
| Rate for Payer: United Healthcare HMO Rider |
$1.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.98
|
| Rate for Payer: Vantage Medical Group Senior |
$2.98
|
|
|
ISONIAZID 300 MG TABLET [4027]
|
Facility
|
IP
|
$3.50
|
|
|
Service Code
|
NDC 64950-217-10
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.70 |
| Max. Negotiated Rate |
$2.98 |
| Rate for Payer: Adventist Health Commercial |
$0.70
|
| Rate for Payer: Blue Shield of California Commercial |
$2.58
|
| Rate for Payer: Blue Shield of California EPN |
$1.70
|
| Rate for Payer: Cash Price |
$1.93
|
| Rate for Payer: Cigna of CA HMO |
$2.45
|
| Rate for Payer: Cigna of CA PPO |
$2.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.40
|
| Rate for Payer: EPIC Health Plan Senior |
$1.40
|
| Rate for Payer: Galaxy Health WC |
$2.98
|
| Rate for Payer: Global Benefits Group Commercial |
$2.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.84
|
| Rate for Payer: Multiplan Commercial |
$2.80
|
| Rate for Payer: Networks By Design Commercial |
$2.27
|
| Rate for Payer: Prime Health Services Commercial |
$2.98
|
|
|
ISONIAZID 50 MG/5 ML ORAL SOLUTION [4025]
|
Facility
|
IP
|
$0.85
|
|
|
Service Code
|
NDC 46287-009-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.72 |
| Rate for Payer: Adventist Health Commercial |
$0.17
|
| Rate for Payer: Blue Shield of California Commercial |
$0.63
|
| Rate for Payer: Blue Shield of California EPN |
$0.41
|
| Rate for Payer: Cash Price |
$0.47
|
| Rate for Payer: Cigna of CA HMO |
$0.60
|
| Rate for Payer: Cigna of CA PPO |
$0.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.34
|
| Rate for Payer: EPIC Health Plan Senior |
$0.34
|
| Rate for Payer: Galaxy Health WC |
$0.72
|
| Rate for Payer: Global Benefits Group Commercial |
$0.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.68
|
| Rate for Payer: Networks By Design Commercial |
$0.55
|
| Rate for Payer: Prime Health Services Commercial |
$0.72
|
|
|
ISONIAZID 50 MG/5 ML ORAL SOLUTION [4025]
|
Facility
|
OP
|
$0.85
|
|
|
Service Code
|
NDC 46287-009-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.72 |
| Rate for Payer: Adventist Health Commercial |
$0.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.52
|
| Rate for Payer: Cash Price |
$0.47
|
| Rate for Payer: Cigna of CA HMO |
$0.60
|
| Rate for Payer: Cigna of CA PPO |
$0.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.34
|
| Rate for Payer: EPIC Health Plan Senior |
$0.34
|
| Rate for Payer: Galaxy Health WC |
$0.72
|
| Rate for Payer: Global Benefits Group Commercial |
$0.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.60
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.60
|
| Rate for Payer: Multiplan Commercial |
$0.68
|
| Rate for Payer: Networks By Design Commercial |
$0.55
|
| Rate for Payer: Prime Health Services Commercial |
$0.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.51
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.43
|
| Rate for Payer: United Healthcare All Other HMO |
$0.43
|
| Rate for Payer: United Healthcare HMO Rider |
$0.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.72
|
| Rate for Payer: Vantage Medical Group Senior |
$0.72
|
|
