|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION [17380]
|
Facility
|
IP
|
$6.90
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.38 |
| Max. Negotiated Rate |
$5.87 |
| Rate for Payer: Cigna of CA HMO |
$17.39
|
| Rate for Payer: Cigna of CA HMO |
$9.24
|
| Rate for Payer: Cigna of CA HMO |
$23.94
|
| Rate for Payer: Cigna of CA HMO |
$4.83
|
| Rate for Payer: Cigna of CA HMO |
$4.96
|
| Rate for Payer: Cigna of CA PPO |
$9.24
|
| Rate for Payer: Cigna of CA PPO |
$23.94
|
| Rate for Payer: Cigna of CA PPO |
$17.39
|
| Rate for Payer: Cigna of CA PPO |
$25.20
|
| Rate for Payer: Cigna of CA PPO |
$4.83
|
| Rate for Payer: Cigna of CA PPO |
$4.96
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Cigna of CA HMO |
$5.04
|
| Rate for Payer: Cigna of CA HMO |
$25.20
|
| Rate for Payer: Adventist Health Commercial |
$1.38
|
| Rate for Payer: Adventist Health Commercial |
$7.20
|
| Rate for Payer: Adventist Health Commercial |
$6.84
|
| Rate for Payer: Adventist Health Commercial |
$2.64
|
| Rate for Payer: Adventist Health Commercial |
$4.97
|
| Rate for Payer: Adventist Health Commercial |
$1.44
|
| Rate for Payer: Adventist Health Commercial |
$1.42
|
| Rate for Payer: Blue Shield of California Commercial |
$19.11
|
| Rate for Payer: Blue Shield of California Commercial |
$12.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6.69
|
| Rate for Payer: Blue Shield of California Commercial |
$17.34
|
| Rate for Payer: Blue Shield of California Commercial |
$5.31
|
| Rate for Payer: Blue Shield of California Commercial |
$5.54
|
| Rate for Payer: Blue Shield of California Commercial |
$3.65
|
| Rate for Payer: Blue Shield of California Commercial |
$3.50
|
| Rate for Payer: Blue Shield of California Commercial |
$5.44
|
| Rate for Payer: Blue Shield of California Commercial |
$3.59
|
| Rate for Payer: Blue Shield of California Commercial |
$27.68
|
| Rate for Payer: Blue Shield of California Commercial |
$26.30
|
| Rate for Payer: Blue Shield of California Commercial |
$10.15
|
| Rate for Payer: Blue Shield of California Commercial |
$18.25
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$3.19
|
| Rate for Payer: Cash Price |
$15.39
|
| Rate for Payer: Cash Price |
$11.18
|
| Rate for Payer: Cash Price |
$3.11
|
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Cash Price |
$3.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.83
|
| Rate for Payer: EPIC Health Plan Senior |
$5.28
|
| Rate for Payer: EPIC Health Plan Senior |
$2.76
|
| Rate for Payer: EPIC Health Plan Senior |
$2.88
|
| Rate for Payer: EPIC Health Plan Senior |
$2.83
|
| Rate for Payer: EPIC Health Plan Senior |
$14.40
|
| Rate for Payer: EPIC Health Plan Senior |
$9.94
|
| Rate for Payer: EPIC Health Plan Senior |
$13.68
|
| Rate for Payer: Galaxy Health WC |
$29.07
|
| Rate for Payer: Galaxy Health WC |
$6.12
|
| Rate for Payer: Galaxy Health WC |
$11.22
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Galaxy Health WC |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$21.12
|
| Rate for Payer: Galaxy Health WC |
$6.02
|
| Rate for Payer: Global Benefits Group Commercial |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4.14
|
| Rate for Payer: Global Benefits Group Commercial |
$4.32
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Global Benefits Group Commercial |
$20.52
|
| Rate for Payer: Global Benefits Group Commercial |
$7.92
|
| Rate for Payer: Global Benefits Group Commercial |
$14.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.78
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.96
|
| Rate for Payer: Multiplan Commercial |
$28.80
|
| Rate for Payer: Multiplan Commercial |
$19.88
|
| Rate for Payer: Multiplan Commercial |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$5.66
|
| Rate for Payer: Multiplan Commercial |
$27.36
|
| Rate for Payer: Multiplan Commercial |
$10.56
|
| Rate for Payer: Multiplan Commercial |
$5.76
|
| Rate for Payer: Networks By Design Commercial |
$3.45
|
| Rate for Payer: Networks By Design Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$3.60
|
| Rate for Payer: Networks By Design Commercial |
$12.43
|
| Rate for Payer: Networks By Design Commercial |
$6.60
|
| Rate for Payer: Networks By Design Commercial |
$17.10
|
| Rate for Payer: Networks By Design Commercial |
$3.54
|
| Rate for Payer: Prime Health Services Commercial |
$11.22
|
| Rate for Payer: Prime Health Services Commercial |
$21.12
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Prime Health Services Commercial |
$29.07
|
| Rate for Payer: Prime Health Services Commercial |
$5.87
|
| Rate for Payer: Prime Health Services Commercial |
$6.02
|
| Rate for Payer: Prime Health Services Commercial |
$6.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.51
|
| Rate for Payer: United Healthcare All Other HMO |
$9.08
|
| Rate for Payer: United Healthcare All Other HMO |
$2.52
|
| Rate for Payer: United Healthcare All Other HMO |
$13.15
|
| Rate for Payer: United Healthcare All Other HMO |
$2.59
|
| Rate for Payer: United Healthcare All Other HMO |
$12.49
|
| Rate for Payer: United Healthcare All Other HMO |
$4.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.63
|
| Rate for Payer: United Healthcare HMO Rider |
$12.22
|
| Rate for Payer: United Healthcare HMO Rider |
$2.57
|
| Rate for Payer: United Healthcare HMO Rider |
$8.88
|
| Rate for Payer: United Healthcare HMO Rider |
$2.47
|
| Rate for Payer: United Healthcare HMO Rider |
$2.53
|
| Rate for Payer: United Healthcare HMO Rider |
$12.87
|
| Rate for Payer: United Healthcare HMO Rider |
$4.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.32
|
|
|
MEROPENEM 1 GRAM INTRAVENOUS SOLUTION [17380]
|
Facility
|
OP
|
$6.90
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$12.25 |
| Rate for Payer: Adventist Health Commercial |
$1.38
|
| Rate for Payer: Adventist Health Commercial |
$4.97
|
| Rate for Payer: Adventist Health Commercial |
$1.44
|
| Rate for Payer: Adventist Health Commercial |
$2.64
|
| Rate for Payer: Adventist Health Commercial |
$1.42
|
| Rate for Payer: Adventist Health Commercial |
$6.84
|
| Rate for Payer: Adventist Health Commercial |
$7.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$21.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$15.39
|
| Rate for Payer: Cash Price |
$3.19
|
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Cash Price |
$3.11
|
| Rate for Payer: Cash Price |
$3.19
|
| Rate for Payer: Cash Price |
$16.20
|
| Rate for Payer: Cash Price |
$3.11
|
| Rate for Payer: Cash Price |
$11.18
|
| Rate for Payer: Cash Price |
$11.18
|
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Cash Price |
$15.39
|
| Rate for Payer: Cash Price |
$3.24
|
| Rate for Payer: Cash Price |
$3.24
|
| Rate for Payer: Cigna of CA HMO |
$23.94
|
| Rate for Payer: Cigna of CA HMO |
$5.04
|
| Rate for Payer: Cigna of CA HMO |
$17.39
|
| Rate for Payer: Cigna of CA HMO |
$9.24
|
| Rate for Payer: Cigna of CA HMO |
$4.96
|
| Rate for Payer: Cigna of CA HMO |
$25.20
|
| Rate for Payer: Cigna of CA HMO |
$4.83
|
| Rate for Payer: Cigna of CA PPO |
$9.24
|
| Rate for Payer: Cigna of CA PPO |
$4.96
|
| Rate for Payer: Cigna of CA PPO |
$25.20
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Cigna of CA PPO |
$4.83
|
| Rate for Payer: Cigna of CA PPO |
$23.94
|
| Rate for Payer: Cigna of CA PPO |
$17.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$21.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$21.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.87
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$21.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$23.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
| Rate for Payer: EPIC Health Plan Senior |
$2.83
|
| Rate for Payer: EPIC Health Plan Senior |
$2.76
|
| Rate for Payer: EPIC Health Plan Senior |
$14.40
|
| Rate for Payer: EPIC Health Plan Senior |
$5.28
|
| Rate for Payer: EPIC Health Plan Senior |
$2.88
|
| Rate for Payer: EPIC Health Plan Senior |
$13.68
|
| Rate for Payer: EPIC Health Plan Senior |
$9.94
|
| Rate for Payer: Galaxy Health WC |
$29.07
|
| Rate for Payer: Galaxy Health WC |
$11.22
|
| Rate for Payer: Galaxy Health WC |
$5.87
|
| Rate for Payer: Galaxy Health WC |
$6.12
|
| Rate for Payer: Galaxy Health WC |
$6.02
|
| Rate for Payer: Galaxy Health WC |
$21.12
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Global Benefits Group Commercial |
$14.91
|
| Rate for Payer: Global Benefits Group Commercial |
$7.92
|
| Rate for Payer: Global Benefits Group Commercial |
$20.52
|
| Rate for Payer: Global Benefits Group Commercial |
$4.14
|
| Rate for Payer: Global Benefits Group Commercial |
$4.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.86
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$21.72
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.41
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$23.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$17.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$23.94
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$17.39
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.20
|
| Rate for Payer: Multiplan Commercial |
$28.80
|
| Rate for Payer: Multiplan Commercial |
$27.36
|
| Rate for Payer: Multiplan Commercial |
$19.88
|
| Rate for Payer: Multiplan Commercial |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$5.76
|
| Rate for Payer: Multiplan Commercial |
$5.66
|
| Rate for Payer: Multiplan Commercial |
$10.56
|
| Rate for Payer: Networks By Design Commercial |
$12.43
|
| Rate for Payer: Networks By Design Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$17.10
|
| Rate for Payer: Networks By Design Commercial |
$3.45
|
| Rate for Payer: Networks By Design Commercial |
$3.54
|
| Rate for Payer: Networks By Design Commercial |
$6.60
|
| Rate for Payer: Networks By Design Commercial |
$3.60
|
| Rate for Payer: Prime Health Services Commercial |
$21.12
|
| Rate for Payer: Prime Health Services Commercial |
$5.87
|
| Rate for Payer: Prime Health Services Commercial |
$29.07
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Prime Health Services Commercial |
$11.22
|
| Rate for Payer: Prime Health Services Commercial |
$6.02
|
| Rate for Payer: Prime Health Services Commercial |
$6.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.91
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.70
|
| Rate for Payer: United Healthcare All Other HMO |
$4.82
|
| Rate for Payer: United Healthcare All Other HMO |
$2.59
|
| Rate for Payer: United Healthcare All Other HMO |
$2.63
|
| Rate for Payer: United Healthcare All Other HMO |
$13.15
|
| Rate for Payer: United Healthcare All Other HMO |
$12.49
|
| Rate for Payer: United Healthcare All Other HMO |
$9.08
|
| Rate for Payer: United Healthcare All Other HMO |
$2.52
|
| Rate for Payer: United Healthcare HMO Rider |
$2.53
|
| Rate for Payer: United Healthcare HMO Rider |
$12.22
|
| Rate for Payer: United Healthcare HMO Rider |
$12.87
|
| Rate for Payer: United Healthcare HMO Rider |
$8.88
|
| Rate for Payer: United Healthcare HMO Rider |
$4.72
|
| Rate for Payer: United Healthcare HMO Rider |
$2.47
|
| Rate for Payer: United Healthcare HMO Rider |
$2.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$21.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$21.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.60
|
| Rate for Payer: Vantage Medical Group Senior |
$5.87
|
| Rate for Payer: Vantage Medical Group Senior |
$6.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.02
|
| Rate for Payer: Vantage Medical Group Senior |
$21.12
|
| Rate for Payer: Vantage Medical Group Senior |
$11.22
|
| Rate for Payer: Vantage Medical Group Senior |
$29.07
|
| Rate for Payer: Vantage Medical Group Senior |
$30.60
|
|
|
MEROPENEM 500 MG INTRAVENOUS SOLUTION [17379]
|
Facility
|
IP
|
$12.36
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$10.51 |
| Rate for Payer: Cigna of CA HMO |
$2.52
|
| Rate for Payer: Cigna of CA HMO |
$8.65
|
| Rate for Payer: Cigna of CA PPO |
$8.65
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Cigna of CA PPO |
$2.52
|
| Rate for Payer: Adventist Health Commercial |
$2.47
|
| Rate for Payer: Adventist Health Commercial |
$0.72
|
| Rate for Payer: Adventist Health Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$2.77
|
| Rate for Payer: Blue Shield of California Commercial |
$6.27
|
| Rate for Payer: Blue Shield of California Commercial |
$9.50
|
| Rate for Payer: Blue Shield of California Commercial |
$5.54
|
| Rate for Payer: Blue Shield of California Commercial |
$3.65
|
| Rate for Payer: Blue Shield of California Commercial |
$1.83
|
| Rate for Payer: Cash Price |
$3.24
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: Cash Price |
$5.56
|
| Rate for Payer: Cigna of CA HMO |
$5.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.94
|
| Rate for Payer: EPIC Health Plan Senior |
$1.44
|
| Rate for Payer: EPIC Health Plan Senior |
$4.94
|
| Rate for Payer: EPIC Health Plan Senior |
$2.88
|
| Rate for Payer: Galaxy Health WC |
$6.12
|
| Rate for Payer: Galaxy Health WC |
$10.51
|
| Rate for Payer: Galaxy Health WC |
$3.06
|
| Rate for Payer: Global Benefits Group Commercial |
$2.16
|
| Rate for Payer: Global Benefits Group Commercial |
$7.42
|
| Rate for Payer: Global Benefits Group Commercial |
$4.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.73
|
| Rate for Payer: Multiplan Commercial |
$9.89
|
| Rate for Payer: Multiplan Commercial |
$2.88
|
| Rate for Payer: Multiplan Commercial |
$5.76
|
| Rate for Payer: Networks By Design Commercial |
$1.80
|
| Rate for Payer: Networks By Design Commercial |
$3.60
|
| Rate for Payer: Networks By Design Commercial |
$6.18
|
| Rate for Payer: Prime Health Services Commercial |
$10.51
|
| Rate for Payer: Prime Health Services Commercial |
$3.06
|
| Rate for Payer: Prime Health Services Commercial |
$6.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.70
|
| Rate for Payer: United Healthcare All Other HMO |
$2.63
|
| Rate for Payer: United Healthcare All Other HMO |
$4.52
|
| Rate for Payer: United Healthcare All Other HMO |
$1.32
|
| Rate for Payer: United Healthcare HMO Rider |
$1.29
|
| Rate for Payer: United Healthcare HMO Rider |
$2.57
|
| Rate for Payer: United Healthcare HMO Rider |
$4.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.18
|
|
|
MEROPENEM 500 MG INTRAVENOUS SOLUTION [17379]
|
Facility
|
OP
|
$3.60
|
|
|
Service Code
|
HCPCS J2185
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$12.25 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.12
|
| Rate for Payer: Vantage Medical Group Senior |
$10.51
|
| Rate for Payer: Vantage Medical Group Senior |
$6.12
|
| Rate for Payer: Vantage Medical Group Senior |
$3.06
|
| Rate for Payer: Adventist Health Commercial |
$0.72
|
| Rate for Payer: Adventist Health Commercial |
$2.47
|
| Rate for Payer: Adventist Health Commercial |
$1.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.27
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.25
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Cash Price |
$5.56
|
| Rate for Payer: Cash Price |
$3.24
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: Cash Price |
$1.62
|
| Rate for Payer: Cash Price |
$3.24
|
| Rate for Payer: Cash Price |
$5.56
|
| Rate for Payer: Cigna of CA HMO |
$2.52
|
| Rate for Payer: Cigna of CA HMO |
$5.04
|
| Rate for Payer: Cigna of CA HMO |
$8.65
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Cigna of CA PPO |
$8.65
|
| Rate for Payer: Cigna of CA PPO |
$2.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.44
|
| Rate for Payer: EPIC Health Plan Senior |
$4.94
|
| Rate for Payer: EPIC Health Plan Senior |
$1.44
|
| Rate for Payer: EPIC Health Plan Senior |
$2.88
|
| Rate for Payer: Galaxy Health WC |
$3.06
|
| Rate for Payer: Galaxy Health WC |
$6.12
|
| Rate for Payer: Galaxy Health WC |
$10.51
|
| Rate for Payer: Global Benefits Group Commercial |
$2.16
|
| Rate for Payer: Global Benefits Group Commercial |
$7.42
|
| Rate for Payer: Global Benefits Group Commercial |
$4.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.52
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.52
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.65
|
| Rate for Payer: Multiplan Commercial |
$2.88
|
| Rate for Payer: Multiplan Commercial |
$5.76
|
| Rate for Payer: Multiplan Commercial |
$9.89
|
| Rate for Payer: Networks By Design Commercial |
$3.60
|
| Rate for Payer: Networks By Design Commercial |
$1.80
|
| Rate for Payer: Networks By Design Commercial |
$6.18
|
| Rate for Payer: Prime Health Services Commercial |
$6.12
|
| Rate for Payer: Prime Health Services Commercial |
$10.51
|
| Rate for Payer: Prime Health Services Commercial |
$3.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.64
|
| Rate for Payer: United Healthcare All Other HMO |
$2.63
|
| Rate for Payer: United Healthcare All Other HMO |
$1.32
|
| Rate for Payer: United Healthcare All Other HMO |
$4.52
|
| Rate for Payer: United Healthcare HMO Rider |
$4.42
|
| Rate for Payer: United Healthcare HMO Rider |
$2.57
|
| Rate for Payer: United Healthcare HMO Rider |
$1.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.12
|
|
|
MEROPENEM-VABORBACTAM 2 GRAM INTRAVENOUS SOLUTION [219863]
|
Facility
|
OP
|
$280.51
|
|
|
Service Code
|
HCPCS J2186
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.22 |
| Max. Negotiated Rate |
$238.43 |
| Rate for Payer: Adventist Health Commercial |
$56.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$13.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.14
|
| Rate for Payer: Blue Shield of California Commercial |
$2.59
|
| Rate for Payer: Cash Price |
$126.23
|
| Rate for Payer: Cash Price |
$126.23
|
| Rate for Payer: Cigna of CA HMO |
$196.36
|
| Rate for Payer: Cigna of CA PPO |
$196.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$196.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.66
|
| Rate for Payer: EPIC Health Plan Senior |
$2.44
|
| Rate for Payer: Galaxy Health WC |
$238.43
|
| Rate for Payer: Global Benefits Group Commercial |
$168.31
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$178.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.97
|
| Rate for Payer: Multiplan Commercial |
$224.41
|
| Rate for Payer: Networks By Design Commercial |
$140.25
|
| Rate for Payer: Prime Health Services Commercial |
$238.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$168.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$168.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$105.28
|
| Rate for Payer: United Healthcare All Other HMO |
$102.47
|
| Rate for Payer: United Healthcare HMO Rider |
$100.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.87
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.44
|
| Rate for Payer: Vantage Medical Group Senior |
$2.44
|
|
|
MEROPENEM-VABORBACTAM 2 GRAM INTRAVENOUS SOLUTION [219863]
|
Facility
|
IP
|
$280.51
|
|
|
Service Code
|
HCPCS J2186
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$56.10 |
| Max. Negotiated Rate |
$238.43 |
| Rate for Payer: Adventist Health Commercial |
$56.10
|
| Rate for Payer: Blue Shield of California Commercial |
$142.22
|
| Rate for Payer: Blue Shield of California Commercial |
$215.71
|
| Rate for Payer: Cash Price |
$126.23
|
| Rate for Payer: Cigna of CA HMO |
$196.36
|
| Rate for Payer: Cigna of CA PPO |
$196.36
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$196.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.20
|
| Rate for Payer: EPIC Health Plan Senior |
$112.20
|
| Rate for Payer: Galaxy Health WC |
$238.43
|
| Rate for Payer: Global Benefits Group Commercial |
$168.31
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$178.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$165.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.32
|
| Rate for Payer: Multiplan Commercial |
$224.41
|
| Rate for Payer: Networks By Design Commercial |
$140.25
|
| Rate for Payer: Prime Health Services Commercial |
$238.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$105.28
|
| Rate for Payer: United Healthcare All Other HMO |
$102.47
|
| Rate for Payer: United Healthcare HMO Rider |
$100.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.87
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY [40369]
|
Facility
|
IP
|
$7.02
|
|
|
Service Code
|
NDC 7071013026
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Adventist Health Commercial |
$1.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3.56
|
| Rate for Payer: Blue Shield of California Commercial |
$5.40
|
| Rate for Payer: Cash Price |
$3.16
|
| Rate for Payer: Cigna of CA HMO |
$4.91
|
| Rate for Payer: Cigna of CA PPO |
$4.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.81
|
| Rate for Payer: EPIC Health Plan Senior |
$2.81
|
| Rate for Payer: Galaxy Health WC |
$5.97
|
| Rate for Payer: Global Benefits Group Commercial |
$4.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.68
|
| Rate for Payer: Multiplan Commercial |
$5.62
|
| Rate for Payer: Networks By Design Commercial |
$4.56
|
| Rate for Payer: Prime Health Services Commercial |
$5.97
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY [40369]
|
Facility
|
IP
|
$7.02
|
|
|
Service Code
|
NDC 7071013027
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Adventist Health Commercial |
$1.40
|
| Rate for Payer: Blue Shield of California Commercial |
$3.56
|
| Rate for Payer: Blue Shield of California Commercial |
$5.40
|
| Rate for Payer: Cash Price |
$3.16
|
| Rate for Payer: Cigna of CA HMO |
$4.91
|
| Rate for Payer: Cigna of CA PPO |
$4.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.81
|
| Rate for Payer: EPIC Health Plan Senior |
$2.81
|
| Rate for Payer: Galaxy Health WC |
$5.97
|
| Rate for Payer: Global Benefits Group Commercial |
$4.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.68
|
| Rate for Payer: Multiplan Commercial |
$5.62
|
| Rate for Payer: Networks By Design Commercial |
$4.56
|
| Rate for Payer: Prime Health Services Commercial |
$5.97
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY [40369]
|
Facility
|
IP
|
$19.10
|
|
|
Service Code
|
NDC 0378923093
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$16.23 |
| Rate for Payer: Adventist Health Commercial |
$3.82
|
| Rate for Payer: Blue Shield of California Commercial |
$14.69
|
| Rate for Payer: Blue Shield of California Commercial |
$9.68
|
| Rate for Payer: Cash Price |
$8.60
|
| Rate for Payer: Cigna of CA HMO |
$13.37
|
| Rate for Payer: Cigna of CA PPO |
$13.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.64
|
| Rate for Payer: EPIC Health Plan Senior |
$7.64
|
| Rate for Payer: Galaxy Health WC |
$16.23
|
| Rate for Payer: Global Benefits Group Commercial |
$11.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.58
|
| Rate for Payer: Multiplan Commercial |
$15.28
|
| Rate for Payer: Networks By Design Commercial |
$12.41
|
| Rate for Payer: Prime Health Services Commercial |
$16.23
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY [40369]
|
Facility
|
IP
|
$6.77
|
|
|
Service Code
|
NDC 5976201183
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$5.75 |
| Rate for Payer: Adventist Health Commercial |
$1.35
|
| Rate for Payer: Blue Shield of California Commercial |
$3.43
|
| Rate for Payer: Blue Shield of California Commercial |
$5.21
|
| Rate for Payer: Cash Price |
$3.05
|
| Rate for Payer: Cigna of CA HMO |
$4.74
|
| Rate for Payer: Cigna of CA PPO |
$4.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.71
|
| Rate for Payer: EPIC Health Plan Senior |
$2.71
|
| Rate for Payer: Galaxy Health WC |
$5.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.62
|
| Rate for Payer: Multiplan Commercial |
$5.42
|
| Rate for Payer: Networks By Design Commercial |
$4.40
|
| Rate for Payer: Prime Health Services Commercial |
$5.75
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY [40369]
|
Facility
|
OP
|
$6.77
|
|
|
Service Code
|
NDC 5976201183
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$5.75 |
| Rate for Payer: Adventist Health Commercial |
$1.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.44
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.34
|
| Rate for Payer: Cash Price |
$3.05
|
| Rate for Payer: Cigna of CA HMO |
$4.74
|
| Rate for Payer: Cigna of CA PPO |
$4.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.71
|
| Rate for Payer: EPIC Health Plan Senior |
$2.71
|
| Rate for Payer: Galaxy Health WC |
$5.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.74
|
| Rate for Payer: Multiplan Commercial |
$5.42
|
| Rate for Payer: Networks By Design Commercial |
$4.40
|
| Rate for Payer: Prime Health Services Commercial |
$5.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.38
|
| Rate for Payer: United Healthcare All Other HMO |
$3.38
|
| Rate for Payer: United Healthcare HMO Rider |
$3.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.75
|
| Rate for Payer: Vantage Medical Group Senior |
$5.75
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY [40369]
|
Facility
|
OP
|
$19.10
|
|
|
Service Code
|
NDC 0378923093
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.82 |
| Max. Negotiated Rate |
$16.23 |
| Rate for Payer: Adventist Health Commercial |
$3.82
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12.26
|
| Rate for Payer: Cash Price |
$8.60
|
| Rate for Payer: Cigna of CA HMO |
$13.37
|
| Rate for Payer: Cigna of CA PPO |
$13.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.64
|
| Rate for Payer: EPIC Health Plan Senior |
$7.64
|
| Rate for Payer: Galaxy Health WC |
$16.23
|
| Rate for Payer: Global Benefits Group Commercial |
$11.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.37
|
| Rate for Payer: Multiplan Commercial |
$15.28
|
| Rate for Payer: Networks By Design Commercial |
$12.41
|
| Rate for Payer: Prime Health Services Commercial |
$16.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.46
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.55
|
| Rate for Payer: United Healthcare All Other HMO |
$9.55
|
| Rate for Payer: United Healthcare HMO Rider |
$9.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.23
|
| Rate for Payer: Vantage Medical Group Senior |
$16.23
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY [40369]
|
Facility
|
OP
|
$7.02
|
|
|
Service Code
|
NDC 7071013026
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Adventist Health Commercial |
$1.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.50
|
| Rate for Payer: Cash Price |
$3.16
|
| Rate for Payer: Cigna of CA HMO |
$4.91
|
| Rate for Payer: Cigna of CA PPO |
$4.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.81
|
| Rate for Payer: EPIC Health Plan Senior |
$2.81
|
| Rate for Payer: Galaxy Health WC |
$5.97
|
| Rate for Payer: Global Benefits Group Commercial |
$4.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.91
|
| Rate for Payer: Multiplan Commercial |
$5.62
|
| Rate for Payer: Networks By Design Commercial |
$4.56
|
| Rate for Payer: Prime Health Services Commercial |
$5.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.51
|
| Rate for Payer: United Healthcare All Other HMO |
$3.51
|
| Rate for Payer: United Healthcare HMO Rider |
$3.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.97
|
| Rate for Payer: Vantage Medical Group Senior |
$5.97
|
|
|
MESALAMINE 1,000 MG RECTAL SUPPOSITORY [40369]
|
Facility
|
OP
|
$7.02
|
|
|
Service Code
|
NDC 7071013027
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.40 |
| Max. Negotiated Rate |
$5.97 |
| Rate for Payer: Adventist Health Commercial |
$1.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.50
|
| Rate for Payer: Cash Price |
$3.16
|
| Rate for Payer: Cigna of CA HMO |
$4.91
|
| Rate for Payer: Cigna of CA PPO |
$4.91
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.81
|
| Rate for Payer: EPIC Health Plan Senior |
$2.81
|
| Rate for Payer: Galaxy Health WC |
$5.97
|
| Rate for Payer: Global Benefits Group Commercial |
$4.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.91
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.91
|
| Rate for Payer: Multiplan Commercial |
$5.62
|
| Rate for Payer: Networks By Design Commercial |
$4.56
|
| Rate for Payer: Prime Health Services Commercial |
$5.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.51
|
| Rate for Payer: United Healthcare All Other HMO |
$3.51
|
| Rate for Payer: United Healthcare HMO Rider |
$3.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.97
|
| Rate for Payer: Vantage Medical Group Senior |
$5.97
|
|
|
MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE [78310]
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
NDC 6068739725
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$10.61 |
| Rate for Payer: Adventist Health Commercial |
$2.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.01
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cigna of CA HMO |
$8.74
|
| Rate for Payer: Cigna of CA PPO |
$8.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.99
|
| Rate for Payer: EPIC Health Plan Senior |
$4.99
|
| Rate for Payer: Galaxy Health WC |
$10.61
|
| Rate for Payer: Global Benefits Group Commercial |
$7.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$9.98
|
| Rate for Payer: Networks By Design Commercial |
$8.11
|
| Rate for Payer: Prime Health Services Commercial |
$10.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.24
|
| Rate for Payer: United Healthcare All Other HMO |
$6.24
|
| Rate for Payer: United Healthcare HMO Rider |
$6.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.61
|
| Rate for Payer: Vantage Medical Group Senior |
$10.61
|
|
|
MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE [78310]
|
Facility
|
OP
|
$12.48
|
|
|
Service Code
|
NDC 6068739795
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$10.61 |
| Rate for Payer: Adventist Health Commercial |
$2.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.01
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cigna of CA HMO |
$8.74
|
| Rate for Payer: Cigna of CA PPO |
$8.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.61
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.61
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.99
|
| Rate for Payer: EPIC Health Plan Senior |
$4.99
|
| Rate for Payer: Galaxy Health WC |
$10.61
|
| Rate for Payer: Global Benefits Group Commercial |
$7.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.74
|
| Rate for Payer: Multiplan Commercial |
$9.98
|
| Rate for Payer: Networks By Design Commercial |
$8.11
|
| Rate for Payer: Prime Health Services Commercial |
$10.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.24
|
| Rate for Payer: United Healthcare All Other HMO |
$6.24
|
| Rate for Payer: United Healthcare HMO Rider |
$6.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.61
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.61
|
| Rate for Payer: Vantage Medical Group Senior |
$10.61
|
|
|
MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE [78310]
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
NDC 6068739795
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$10.61 |
| Rate for Payer: Adventist Health Commercial |
$2.50
|
| Rate for Payer: Blue Shield of California Commercial |
$6.33
|
| Rate for Payer: Blue Shield of California Commercial |
$9.60
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cigna of CA HMO |
$8.74
|
| Rate for Payer: Cigna of CA PPO |
$8.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.99
|
| Rate for Payer: EPIC Health Plan Senior |
$4.99
|
| Rate for Payer: Galaxy Health WC |
$10.61
|
| Rate for Payer: Global Benefits Group Commercial |
$7.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$9.98
|
| Rate for Payer: Networks By Design Commercial |
$8.11
|
| Rate for Payer: Prime Health Services Commercial |
$10.61
|
|
|
MESALAMINE 1.2 GRAM TABLET,DELAYED RELEASE [78310]
|
Facility
|
IP
|
$12.48
|
|
|
Service Code
|
NDC 6068739725
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$10.61 |
| Rate for Payer: Adventist Health Commercial |
$2.50
|
| Rate for Payer: Blue Shield of California Commercial |
$6.33
|
| Rate for Payer: Blue Shield of California Commercial |
$9.60
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cigna of CA HMO |
$8.74
|
| Rate for Payer: Cigna of CA PPO |
$8.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.99
|
| Rate for Payer: EPIC Health Plan Senior |
$4.99
|
| Rate for Payer: Galaxy Health WC |
$10.61
|
| Rate for Payer: Global Benefits Group Commercial |
$7.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$9.98
|
| Rate for Payer: Networks By Design Commercial |
$8.11
|
| Rate for Payer: Prime Health Services Commercial |
$10.61
|
|
|
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE) [214804]
|
Facility
|
IP
|
$8.33
|
|
|
Service Code
|
NDC 6068755633
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$7.08 |
| Rate for Payer: Adventist Health Commercial |
$1.67
|
| Rate for Payer: Blue Shield of California Commercial |
$4.22
|
| Rate for Payer: Blue Shield of California Commercial |
$6.41
|
| Rate for Payer: Cash Price |
$3.75
|
| Rate for Payer: Cigna of CA HMO |
$5.83
|
| Rate for Payer: Cigna of CA PPO |
$5.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.33
|
| Rate for Payer: EPIC Health Plan Senior |
$3.33
|
| Rate for Payer: Galaxy Health WC |
$7.08
|
| Rate for Payer: Global Benefits Group Commercial |
$5.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Multiplan Commercial |
$6.66
|
| Rate for Payer: Networks By Design Commercial |
$5.41
|
| Rate for Payer: Prime Health Services Commercial |
$7.08
|
|
|
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE) [214804]
|
Facility
|
OP
|
$8.33
|
|
|
Service Code
|
NDC 6068755632
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$7.08 |
| Rate for Payer: Adventist Health Commercial |
$1.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.35
|
| Rate for Payer: Cash Price |
$3.75
|
| Rate for Payer: Cigna of CA HMO |
$5.83
|
| Rate for Payer: Cigna of CA PPO |
$5.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.33
|
| Rate for Payer: EPIC Health Plan Senior |
$3.33
|
| Rate for Payer: Galaxy Health WC |
$7.08
|
| Rate for Payer: Global Benefits Group Commercial |
$5.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.83
|
| Rate for Payer: Multiplan Commercial |
$6.66
|
| Rate for Payer: Networks By Design Commercial |
$5.41
|
| Rate for Payer: Prime Health Services Commercial |
$7.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.17
|
| Rate for Payer: United Healthcare All Other HMO |
$4.17
|
| Rate for Payer: United Healthcare HMO Rider |
$4.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.08
|
| Rate for Payer: Vantage Medical Group Senior |
$7.08
|
|
|
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE) [214804]
|
Facility
|
IP
|
$8.33
|
|
|
Service Code
|
NDC 6068755632
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$7.08 |
| Rate for Payer: Adventist Health Commercial |
$1.67
|
| Rate for Payer: Blue Shield of California Commercial |
$4.22
|
| Rate for Payer: Blue Shield of California Commercial |
$6.41
|
| Rate for Payer: Cash Price |
$3.75
|
| Rate for Payer: Cigna of CA HMO |
$5.83
|
| Rate for Payer: Cigna of CA PPO |
$5.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.33
|
| Rate for Payer: EPIC Health Plan Senior |
$3.33
|
| Rate for Payer: Galaxy Health WC |
$7.08
|
| Rate for Payer: Global Benefits Group Commercial |
$5.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Multiplan Commercial |
$6.66
|
| Rate for Payer: Networks By Design Commercial |
$5.41
|
| Rate for Payer: Prime Health Services Commercial |
$7.08
|
|
|
MESALAMINE 400 MG CAPSULE (WITH DELAYED RELEASE TABLETS INSIDE) [214804]
|
Facility
|
OP
|
$8.33
|
|
|
Service Code
|
NDC 6068755633
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.67 |
| Max. Negotiated Rate |
$7.08 |
| Rate for Payer: Adventist Health Commercial |
$1.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.35
|
| Rate for Payer: Cash Price |
$3.75
|
| Rate for Payer: Cigna of CA HMO |
$5.83
|
| Rate for Payer: Cigna of CA PPO |
$5.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.33
|
| Rate for Payer: EPIC Health Plan Senior |
$3.33
|
| Rate for Payer: Galaxy Health WC |
$7.08
|
| Rate for Payer: Global Benefits Group Commercial |
$5.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.83
|
| Rate for Payer: Multiplan Commercial |
$6.66
|
| Rate for Payer: Networks By Design Commercial |
$5.41
|
| Rate for Payer: Prime Health Services Commercial |
$7.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.17
|
| Rate for Payer: United Healthcare All Other HMO |
$4.17
|
| Rate for Payer: United Healthcare HMO Rider |
$4.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.08
|
| Rate for Payer: Vantage Medical Group Senior |
$7.08
|
|
|
MESALAMINE 4 GRAM/60 ML ENEMA [10535]
|
Facility
|
OP
|
$0.27
|
|
|
Service Code
|
NDC 6255942007
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.23 |
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.17
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cigna of CA HMO |
$0.19
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Senior |
$0.11
|
| Rate for Payer: Galaxy Health WC |
$0.23
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.19
|
| Rate for Payer: Multiplan Commercial |
$0.22
|
| Rate for Payer: Networks By Design Commercial |
$0.18
|
| Rate for Payer: Prime Health Services Commercial |
$0.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.14
|
| Rate for Payer: United Healthcare All Other HMO |
$0.14
|
| Rate for Payer: United Healthcare HMO Rider |
$0.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.23
|
| Rate for Payer: Vantage Medical Group Senior |
$0.23
|
|
|
MESALAMINE 4 GRAM/60 ML ENEMA [10535]
|
Facility
|
OP
|
$0.26
|
|
|
Service Code
|
NDC 4580209846
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.22 |
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.17
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cigna of CA HMO |
$0.18
|
| Rate for Payer: Cigna of CA PPO |
$0.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Senior |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.21
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
| Rate for Payer: United Healthcare All Other HMO |
$0.13
|
| Rate for Payer: United Healthcare HMO Rider |
$0.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.22
|
| Rate for Payer: Vantage Medical Group Senior |
$0.22
|
|
|
MESALAMINE 4 GRAM/60 ML ENEMA [10535]
|
Facility
|
IP
|
$0.20
|
|
|
Service Code
|
NDC 4580209851
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.17 |
| Rate for Payer: Adventist Health Commercial |
$0.04
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California Commercial |
$0.15
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cigna of CA HMO |
$0.14
|
| Rate for Payer: Cigna of CA PPO |
$0.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: EPIC Health Plan Senior |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.17
|
| Rate for Payer: Global Benefits Group Commercial |
$0.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.16
|
| Rate for Payer: Networks By Design Commercial |
$0.13
|
| Rate for Payer: Prime Health Services Commercial |
$0.17
|
|
