|
METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [4991]
|
Facility
|
OP
|
$1.37
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$1.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Adventist Health Commercial |
$0.27
|
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.99
|
| Rate for Payer: Blue Shield of California Commercial |
$0.37
|
| Rate for Payer: Blue Shield of California Commercial |
$0.37
|
| Rate for Payer: Cash Price |
$0.17
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: Cash Price |
$0.17
|
| Rate for Payer: Cigna of CA HMO |
$0.96
|
| Rate for Payer: Cigna of CA HMO |
$0.26
|
| Rate for Payer: Cigna of CA PPO |
$0.26
|
| Rate for Payer: Cigna of CA PPO |
$0.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.31
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.15
|
| Rate for Payer: EPIC Health Plan Senior |
$0.55
|
| Rate for Payer: EPIC Health Plan Senior |
$0.15
|
| Rate for Payer: Galaxy Health WC |
$1.16
|
| Rate for Payer: Galaxy Health WC |
$0.31
|
| Rate for Payer: Global Benefits Group Commercial |
$0.82
|
| Rate for Payer: Global Benefits Group Commercial |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.26
|
| Rate for Payer: Multiplan Commercial |
$1.10
|
| Rate for Payer: Multiplan Commercial |
$0.30
|
| Rate for Payer: Networks By Design Commercial |
$0.69
|
| Rate for Payer: Networks By Design Commercial |
$0.19
|
| Rate for Payer: Prime Health Services Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$1.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.51
|
| Rate for Payer: United Healthcare All Other HMO |
$0.14
|
| Rate for Payer: United Healthcare All Other HMO |
$0.50
|
| Rate for Payer: United Healthcare HMO Rider |
$0.49
|
| Rate for Payer: United Healthcare HMO Rider |
$0.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.16
|
| Rate for Payer: Vantage Medical Group Senior |
$0.31
|
| Rate for Payer: Vantage Medical Group Senior |
$1.16
|
|
|
METHYLPREDNISOLONE 500 MG INJ WRAP FOR CNR USE ONLY [4081203]
|
Facility
|
IP
|
$56.86
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.37 |
| Max. Negotiated Rate |
$48.33 |
| Rate for Payer: Adventist Health Commercial |
$11.37
|
| Rate for Payer: Adventist Health Commercial |
$5.83
|
| Rate for Payer: Blue Shield of California Commercial |
$22.41
|
| Rate for Payer: Blue Shield of California Commercial |
$28.83
|
| Rate for Payer: Blue Shield of California Commercial |
$43.73
|
| Rate for Payer: Blue Shield of California Commercial |
$14.77
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$25.59
|
| Rate for Payer: Cigna of CA HMO |
$39.80
|
| Rate for Payer: Cigna of CA HMO |
$20.40
|
| Rate for Payer: Cigna of CA PPO |
$20.40
|
| Rate for Payer: Cigna of CA PPO |
$39.80
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.74
|
| Rate for Payer: EPIC Health Plan Senior |
$11.66
|
| Rate for Payer: EPIC Health Plan Senior |
$22.74
|
| Rate for Payer: Galaxy Health WC |
$24.77
|
| Rate for Payer: Galaxy Health WC |
$48.33
|
| Rate for Payer: Global Benefits Group Commercial |
$34.12
|
| Rate for Payer: Global Benefits Group Commercial |
$17.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.65
|
| Rate for Payer: Multiplan Commercial |
$23.31
|
| Rate for Payer: Multiplan Commercial |
$45.49
|
| Rate for Payer: Networks By Design Commercial |
$28.43
|
| Rate for Payer: Networks By Design Commercial |
$14.57
|
| Rate for Payer: Prime Health Services Commercial |
$48.33
|
| Rate for Payer: Prime Health Services Commercial |
$24.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.34
|
| Rate for Payer: United Healthcare All Other HMO |
$20.77
|
| Rate for Payer: United Healthcare All Other HMO |
$10.64
|
| Rate for Payer: United Healthcare HMO Rider |
$10.41
|
| Rate for Payer: United Healthcare HMO Rider |
$20.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.62
|
|
|
METHYLPREDNISOLONE 500 MG INJ WRAP FOR CNR USE ONLY [4081203]
|
Facility
|
OP
|
$29.14
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$24.77 |
| Rate for Payer: Adventist Health Commercial |
$5.83
|
| Rate for Payer: Adventist Health Commercial |
$11.37
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$25.59
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$25.59
|
| Rate for Payer: Cigna of CA HMO |
$39.80
|
| Rate for Payer: Cigna of CA HMO |
$20.40
|
| Rate for Payer: Cigna of CA PPO |
$39.80
|
| Rate for Payer: Cigna of CA PPO |
$20.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$48.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$48.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$39.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.74
|
| Rate for Payer: EPIC Health Plan Senior |
$22.74
|
| Rate for Payer: EPIC Health Plan Senior |
$11.66
|
| Rate for Payer: Galaxy Health WC |
$48.33
|
| Rate for Payer: Galaxy Health WC |
$24.77
|
| Rate for Payer: Global Benefits Group Commercial |
$34.12
|
| Rate for Payer: Global Benefits Group Commercial |
$17.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$36.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$33.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.80
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.80
|
| Rate for Payer: Multiplan Commercial |
$45.49
|
| Rate for Payer: Multiplan Commercial |
$23.31
|
| Rate for Payer: Networks By Design Commercial |
$28.43
|
| Rate for Payer: Networks By Design Commercial |
$14.57
|
| Rate for Payer: Prime Health Services Commercial |
$24.77
|
| Rate for Payer: Prime Health Services Commercial |
$48.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$34.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$34.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.34
|
| Rate for Payer: United Healthcare All Other HMO |
$10.64
|
| Rate for Payer: United Healthcare All Other HMO |
$20.77
|
| Rate for Payer: United Healthcare HMO Rider |
$20.32
|
| Rate for Payer: United Healthcare HMO Rider |
$10.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$48.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$48.33
|
| Rate for Payer: Vantage Medical Group Senior |
$24.77
|
| Rate for Payer: Vantage Medical Group Senior |
$48.33
|
|
|
METHYLPREDNISOLONE 8 MG TABLET [10576]
|
Facility
|
OP
|
$1.93
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$1.64 |
| Rate for Payer: Adventist Health Commercial |
$0.39
|
| Rate for Payer: Adventist Health Commercial |
$0.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.99
|
| Rate for Payer: Blue Shield of California Commercial |
$0.37
|
| Rate for Payer: Blue Shield of California Commercial |
$0.37
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cash Price |
$0.87
|
| Rate for Payer: Cash Price |
$0.87
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cigna of CA HMO |
$1.35
|
| Rate for Payer: Cigna of CA HMO |
$1.21
|
| Rate for Payer: Cigna of CA PPO |
$1.21
|
| Rate for Payer: Cigna of CA PPO |
$1.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.47
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.64
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Senior |
$0.77
|
| Rate for Payer: EPIC Health Plan Senior |
$0.69
|
| Rate for Payer: Galaxy Health WC |
$1.64
|
| Rate for Payer: Galaxy Health WC |
$1.47
|
| Rate for Payer: Global Benefits Group Commercial |
$1.16
|
| Rate for Payer: Global Benefits Group Commercial |
$1.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.21
|
| Rate for Payer: Multiplan Commercial |
$1.54
|
| Rate for Payer: Multiplan Commercial |
$1.38
|
| Rate for Payer: Networks By Design Commercial |
$0.97
|
| Rate for Payer: Networks By Design Commercial |
$0.87
|
| Rate for Payer: Prime Health Services Commercial |
$1.47
|
| Rate for Payer: Prime Health Services Commercial |
$1.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.72
|
| Rate for Payer: United Healthcare All Other HMO |
$0.63
|
| Rate for Payer: United Healthcare All Other HMO |
$0.71
|
| Rate for Payer: United Healthcare HMO Rider |
$0.69
|
| Rate for Payer: United Healthcare HMO Rider |
$0.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1.47
|
| Rate for Payer: Vantage Medical Group Senior |
$1.64
|
|
|
METHYLPREDNISOLONE 8 MG TABLET [10576]
|
Facility
|
IP
|
$1.93
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$1.64 |
| Rate for Payer: Adventist Health Commercial |
$0.39
|
| Rate for Payer: Adventist Health Commercial |
$0.35
|
| Rate for Payer: Blue Shield of California Commercial |
$1.33
|
| Rate for Payer: Blue Shield of California Commercial |
$0.98
|
| Rate for Payer: Blue Shield of California Commercial |
$1.48
|
| Rate for Payer: Blue Shield of California Commercial |
$0.88
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cash Price |
$0.87
|
| Rate for Payer: Cigna of CA HMO |
$1.35
|
| Rate for Payer: Cigna of CA HMO |
$1.21
|
| Rate for Payer: Cigna of CA PPO |
$1.21
|
| Rate for Payer: Cigna of CA PPO |
$1.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Senior |
$0.69
|
| Rate for Payer: EPIC Health Plan Senior |
$0.77
|
| Rate for Payer: Galaxy Health WC |
$1.47
|
| Rate for Payer: Galaxy Health WC |
$1.64
|
| Rate for Payer: Global Benefits Group Commercial |
$1.16
|
| Rate for Payer: Global Benefits Group Commercial |
$1.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.46
|
| Rate for Payer: Multiplan Commercial |
$1.38
|
| Rate for Payer: Multiplan Commercial |
$1.54
|
| Rate for Payer: Networks By Design Commercial |
$0.97
|
| Rate for Payer: Networks By Design Commercial |
$0.87
|
| Rate for Payer: Prime Health Services Commercial |
$1.64
|
| Rate for Payer: Prime Health Services Commercial |
$1.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.72
|
| Rate for Payer: United Healthcare All Other HMO |
$0.71
|
| Rate for Payer: United Healthcare All Other HMO |
$0.63
|
| Rate for Payer: United Healthcare HMO Rider |
$0.62
|
| Rate for Payer: United Healthcare HMO Rider |
$0.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.63
|
|
|
METHYLPREDNISOLONE ACETATE 20 MG/ML SUSPENSION FOR INJECTION [4994]
|
Facility
|
IP
|
$8.53
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.71 |
| Max. Negotiated Rate |
$7.25 |
| Rate for Payer: Adventist Health Commercial |
$1.71
|
| Rate for Payer: Blue Shield of California Commercial |
$4.32
|
| Rate for Payer: Blue Shield of California Commercial |
$6.56
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Cigna of CA HMO |
$5.97
|
| Rate for Payer: Cigna of CA PPO |
$5.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.41
|
| Rate for Payer: EPIC Health Plan Senior |
$3.41
|
| Rate for Payer: Galaxy Health WC |
$7.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.05
|
| Rate for Payer: Multiplan Commercial |
$6.82
|
| Rate for Payer: Networks By Design Commercial |
$4.26
|
| Rate for Payer: Prime Health Services Commercial |
$7.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.20
|
| Rate for Payer: United Healthcare All Other HMO |
$3.12
|
| Rate for Payer: United Healthcare HMO Rider |
$3.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.79
|
|
|
METHYLPREDNISOLONE ACETATE 20 MG/ML SUSPENSION FOR INJECTION [4994]
|
Facility
|
OP
|
$8.53
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$8.70 |
| Rate for Payer: Adventist Health Commercial |
$1.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Cigna of CA HMO |
$5.97
|
| Rate for Payer: Cigna of CA PPO |
$5.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.41
|
| Rate for Payer: EPIC Health Plan Senior |
$3.41
|
| Rate for Payer: Galaxy Health WC |
$7.25
|
| Rate for Payer: Global Benefits Group Commercial |
$5.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.97
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.97
|
| Rate for Payer: Multiplan Commercial |
$6.82
|
| Rate for Payer: Networks By Design Commercial |
$4.26
|
| Rate for Payer: Prime Health Services Commercial |
$7.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.20
|
| Rate for Payer: United Healthcare All Other HMO |
$3.12
|
| Rate for Payer: United Healthcare HMO Rider |
$3.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.25
|
| Rate for Payer: Vantage Medical Group Senior |
$7.25
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]
|
Facility
|
IP
|
$11.57
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$9.83 |
| Rate for Payer: Adventist Health Commercial |
$2.31
|
| Rate for Payer: Adventist Health Commercial |
$2.73
|
| Rate for Payer: Adventist Health Commercial |
$2.73
|
| Rate for Payer: Blue Shield of California Commercial |
$6.91
|
| Rate for Payer: Blue Shield of California Commercial |
$5.87
|
| Rate for Payer: Blue Shield of California Commercial |
$8.90
|
| Rate for Payer: Blue Shield of California Commercial |
$6.92
|
| Rate for Payer: Blue Shield of California Commercial |
$10.49
|
| Rate for Payer: Blue Shield of California Commercial |
$10.48
|
| Rate for Payer: Cash Price |
$6.14
|
| Rate for Payer: Cash Price |
$6.13
|
| Rate for Payer: Cash Price |
$5.21
|
| Rate for Payer: Cigna of CA HMO |
$9.55
|
| Rate for Payer: Cigna of CA HMO |
$9.54
|
| Rate for Payer: Cigna of CA HMO |
$8.10
|
| Rate for Payer: Cigna of CA PPO |
$8.10
|
| Rate for Payer: Cigna of CA PPO |
$9.55
|
| Rate for Payer: Cigna of CA PPO |
$9.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.63
|
| Rate for Payer: EPIC Health Plan Senior |
$5.45
|
| Rate for Payer: EPIC Health Plan Senior |
$4.63
|
| Rate for Payer: EPIC Health Plan Senior |
$5.46
|
| Rate for Payer: Galaxy Health WC |
$11.59
|
| Rate for Payer: Galaxy Health WC |
$9.83
|
| Rate for Payer: Galaxy Health WC |
$11.59
|
| Rate for Payer: Global Benefits Group Commercial |
$8.18
|
| Rate for Payer: Global Benefits Group Commercial |
$6.94
|
| Rate for Payer: Global Benefits Group Commercial |
$8.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.27
|
| Rate for Payer: Multiplan Commercial |
$9.26
|
| Rate for Payer: Multiplan Commercial |
$10.90
|
| Rate for Payer: Multiplan Commercial |
$10.91
|
| Rate for Payer: Networks By Design Commercial |
$6.82
|
| Rate for Payer: Networks By Design Commercial |
$6.82
|
| Rate for Payer: Networks By Design Commercial |
$5.79
|
| Rate for Payer: Prime Health Services Commercial |
$9.83
|
| Rate for Payer: Prime Health Services Commercial |
$11.59
|
| Rate for Payer: Prime Health Services Commercial |
$11.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.12
|
| Rate for Payer: United Healthcare All Other HMO |
$4.98
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare All Other HMO |
$4.98
|
| Rate for Payer: United Healthcare HMO Rider |
$4.87
|
| Rate for Payer: United Healthcare HMO Rider |
$4.87
|
| Rate for Payer: United Healthcare HMO Rider |
$4.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.46
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]
|
Facility
|
OP
|
$13.63
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$11.59 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.59
|
| Rate for Payer: Vantage Medical Group Senior |
$9.83
|
| Rate for Payer: Vantage Medical Group Senior |
$11.59
|
| Rate for Payer: Vantage Medical Group Senior |
$11.59
|
| Rate for Payer: Adventist Health Commercial |
$2.73
|
| Rate for Payer: Adventist Health Commercial |
$2.31
|
| Rate for Payer: Adventist Health Commercial |
$2.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$6.14
|
| Rate for Payer: Cash Price |
$6.13
|
| Rate for Payer: Cash Price |
$5.21
|
| Rate for Payer: Cash Price |
$6.13
|
| Rate for Payer: Cash Price |
$6.14
|
| Rate for Payer: Cash Price |
$5.21
|
| Rate for Payer: Cigna of CA HMO |
$9.55
|
| Rate for Payer: Cigna of CA HMO |
$9.54
|
| Rate for Payer: Cigna of CA HMO |
$8.10
|
| Rate for Payer: Cigna of CA PPO |
$8.10
|
| Rate for Payer: Cigna of CA PPO |
$9.55
|
| Rate for Payer: Cigna of CA PPO |
$9.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.46
|
| Rate for Payer: EPIC Health Plan Senior |
$5.46
|
| Rate for Payer: EPIC Health Plan Senior |
$4.63
|
| Rate for Payer: EPIC Health Plan Senior |
$5.45
|
| Rate for Payer: Galaxy Health WC |
$11.59
|
| Rate for Payer: Galaxy Health WC |
$11.59
|
| Rate for Payer: Galaxy Health WC |
$9.83
|
| Rate for Payer: Global Benefits Group Commercial |
$8.18
|
| Rate for Payer: Global Benefits Group Commercial |
$6.94
|
| Rate for Payer: Global Benefits Group Commercial |
$8.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.54
|
| Rate for Payer: Multiplan Commercial |
$10.90
|
| Rate for Payer: Multiplan Commercial |
$10.91
|
| Rate for Payer: Multiplan Commercial |
$9.26
|
| Rate for Payer: Networks By Design Commercial |
$6.82
|
| Rate for Payer: Networks By Design Commercial |
$6.82
|
| Rate for Payer: Networks By Design Commercial |
$5.79
|
| Rate for Payer: Prime Health Services Commercial |
$11.59
|
| Rate for Payer: Prime Health Services Commercial |
$9.83
|
| Rate for Payer: Prime Health Services Commercial |
$11.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.34
|
| Rate for Payer: United Healthcare All Other HMO |
$4.98
|
| Rate for Payer: United Healthcare All Other HMO |
$4.98
|
| Rate for Payer: United Healthcare All Other HMO |
$4.23
|
| Rate for Payer: United Healthcare HMO Rider |
$4.14
|
| Rate for Payer: United Healthcare HMO Rider |
$4.87
|
| Rate for Payer: United Healthcare HMO Rider |
$4.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.79
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.83
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION [4996]
|
Facility
|
IP
|
$19.58
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.92 |
| Max. Negotiated Rate |
$16.64 |
| Rate for Payer: Adventist Health Commercial |
$3.92
|
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Blue Shield of California Commercial |
$18.19
|
| Rate for Payer: Blue Shield of California Commercial |
$15.06
|
| Rate for Payer: Blue Shield of California Commercial |
$9.93
|
| Rate for Payer: Blue Shield of California Commercial |
$18.20
|
| Rate for Payer: Blue Shield of California Commercial |
$12.00
|
| Rate for Payer: Blue Shield of California Commercial |
$12.00
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$8.81
|
| Rate for Payer: Cigna of CA HMO |
$16.57
|
| Rate for Payer: Cigna of CA HMO |
$16.56
|
| Rate for Payer: Cigna of CA HMO |
$13.71
|
| Rate for Payer: Cigna of CA PPO |
$13.71
|
| Rate for Payer: Cigna of CA PPO |
$16.57
|
| Rate for Payer: Cigna of CA PPO |
$16.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.83
|
| Rate for Payer: EPIC Health Plan Senior |
$9.46
|
| Rate for Payer: EPIC Health Plan Senior |
$7.83
|
| Rate for Payer: EPIC Health Plan Senior |
$9.47
|
| Rate for Payer: Galaxy Health WC |
$20.12
|
| Rate for Payer: Galaxy Health WC |
$16.64
|
| Rate for Payer: Galaxy Health WC |
$20.11
|
| Rate for Payer: Global Benefits Group Commercial |
$14.20
|
| Rate for Payer: Global Benefits Group Commercial |
$11.75
|
| Rate for Payer: Global Benefits Group Commercial |
$14.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.97
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.68
|
| Rate for Payer: Multiplan Commercial |
$15.66
|
| Rate for Payer: Multiplan Commercial |
$18.93
|
| Rate for Payer: Multiplan Commercial |
$18.94
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Networks By Design Commercial |
$11.84
|
| Rate for Payer: Networks By Design Commercial |
$9.79
|
| Rate for Payer: Prime Health Services Commercial |
$16.64
|
| Rate for Payer: Prime Health Services Commercial |
$20.11
|
| Rate for Payer: Prime Health Services Commercial |
$20.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.88
|
| Rate for Payer: United Healthcare All Other HMO |
$8.65
|
| Rate for Payer: United Healthcare All Other HMO |
$7.15
|
| Rate for Payer: United Healthcare All Other HMO |
$8.64
|
| Rate for Payer: United Healthcare HMO Rider |
$8.46
|
| Rate for Payer: United Healthcare HMO Rider |
$8.46
|
| Rate for Payer: United Healthcare HMO Rider |
$7.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.75
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION [4996]
|
Facility
|
OP
|
$23.66
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$20.11 |
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Adventist Health Commercial |
$3.92
|
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$20.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$13.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$17.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$8.81
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$8.81
|
| Rate for Payer: Cigna of CA HMO |
$16.57
|
| Rate for Payer: Cigna of CA HMO |
$16.56
|
| Rate for Payer: Cigna of CA HMO |
$13.71
|
| Rate for Payer: Cigna of CA PPO |
$13.71
|
| Rate for Payer: Cigna of CA PPO |
$16.57
|
| Rate for Payer: Cigna of CA PPO |
$16.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$20.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$16.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.47
|
| Rate for Payer: EPIC Health Plan Senior |
$9.47
|
| Rate for Payer: EPIC Health Plan Senior |
$7.83
|
| Rate for Payer: EPIC Health Plan Senior |
$9.46
|
| Rate for Payer: Galaxy Health WC |
$20.11
|
| Rate for Payer: Galaxy Health WC |
$20.12
|
| Rate for Payer: Galaxy Health WC |
$16.64
|
| Rate for Payer: Global Benefits Group Commercial |
$14.20
|
| Rate for Payer: Global Benefits Group Commercial |
$11.75
|
| Rate for Payer: Global Benefits Group Commercial |
$14.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$13.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$16.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$13.71
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$16.56
|
| Rate for Payer: Multiplan Commercial |
$18.93
|
| Rate for Payer: Multiplan Commercial |
$18.94
|
| Rate for Payer: Multiplan Commercial |
$15.66
|
| Rate for Payer: Networks By Design Commercial |
$11.84
|
| Rate for Payer: Networks By Design Commercial |
$11.83
|
| Rate for Payer: Networks By Design Commercial |
$9.79
|
| Rate for Payer: Prime Health Services Commercial |
$20.12
|
| Rate for Payer: Prime Health Services Commercial |
$16.64
|
| Rate for Payer: Prime Health Services Commercial |
$20.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.75
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.35
|
| Rate for Payer: United Healthcare All Other HMO |
$8.65
|
| Rate for Payer: United Healthcare All Other HMO |
$8.64
|
| Rate for Payer: United Healthcare All Other HMO |
$7.15
|
| Rate for Payer: United Healthcare HMO Rider |
$7.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8.46
|
| Rate for Payer: United Healthcare HMO Rider |
$8.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$20.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.12
|
| Rate for Payer: Vantage Medical Group Senior |
$16.64
|
| Rate for Payer: Vantage Medical Group Senior |
$20.12
|
| Rate for Payer: Vantage Medical Group Senior |
$20.11
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION [10577]
|
Facility
|
OP
|
$50.27
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$42.73 |
| Rate for Payer: United Healthcare HMO Rider |
$17.97
|
| Rate for Payer: United Healthcare HMO Rider |
$10.87
|
| Rate for Payer: United Healthcare HMO Rider |
$18.86
|
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Adventist Health Commercial |
$8.21
|
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$44.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$25.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$34.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$42.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$29.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$27.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$22.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$37.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$39.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$22.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cash Price |
$23.75
|
| Rate for Payer: Cash Price |
$23.75
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cigna of CA HMO |
$21.29
|
| Rate for Payer: Cigna of CA HMO |
$28.74
|
| Rate for Payer: Cigna of CA HMO |
$35.19
|
| Rate for Payer: Cigna of CA HMO |
$36.95
|
| Rate for Payer: Cigna of CA PPO |
$35.19
|
| Rate for Payer: Cigna of CA PPO |
$21.29
|
| Rate for Payer: Cigna of CA PPO |
$28.74
|
| Rate for Payer: Cigna of CA PPO |
$36.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$25.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$25.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$34.90
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$44.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.11
|
| Rate for Payer: EPIC Health Plan Senior |
$20.11
|
| Rate for Payer: EPIC Health Plan Senior |
$12.17
|
| Rate for Payer: EPIC Health Plan Senior |
$16.42
|
| Rate for Payer: EPIC Health Plan Senior |
$21.11
|
| Rate for Payer: Galaxy Health WC |
$42.73
|
| Rate for Payer: Galaxy Health WC |
$34.90
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Galaxy Health WC |
$44.86
|
| Rate for Payer: Global Benefits Group Commercial |
$24.64
|
| Rate for Payer: Global Benefits Group Commercial |
$31.67
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Global Benefits Group Commercial |
$30.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.32
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$21.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$35.19
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$36.95
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$28.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$21.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36.95
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$28.74
|
| Rate for Payer: Multiplan Commercial |
$32.85
|
| Rate for Payer: Multiplan Commercial |
$24.34
|
| Rate for Payer: Multiplan Commercial |
$40.22
|
| Rate for Payer: Multiplan Commercial |
$42.22
|
| Rate for Payer: Networks By Design Commercial |
$26.39
|
| Rate for Payer: Networks By Design Commercial |
$20.53
|
| Rate for Payer: Networks By Design Commercial |
$15.21
|
| Rate for Payer: Networks By Design Commercial |
$25.14
|
| Rate for Payer: Prime Health Services Commercial |
$34.90
|
| Rate for Payer: Prime Health Services Commercial |
$42.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
| Rate for Payer: Prime Health Services Commercial |
$44.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$30.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$18.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$24.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$30.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$18.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$24.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.87
|
| Rate for Payer: United Healthcare All Other HMO |
$18.36
|
| Rate for Payer: United Healthcare All Other HMO |
$19.28
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare All Other HMO |
$15.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$25.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$44.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$34.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$42.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$25.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.90
|
| Rate for Payer: Vantage Medical Group Senior |
$44.86
|
| Rate for Payer: Vantage Medical Group Senior |
$34.90
|
| Rate for Payer: Vantage Medical Group Senior |
$42.73
|
| Rate for Payer: Vantage Medical Group Senior |
$25.86
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION [10577]
|
Facility
|
IP
|
$41.06
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$8.21 |
| Max. Negotiated Rate |
$34.90 |
| Rate for Payer: Multiplan Commercial |
$32.85
|
| Rate for Payer: Multiplan Commercial |
$42.22
|
| Rate for Payer: Networks By Design Commercial |
$20.53
|
| Rate for Payer: Networks By Design Commercial |
$25.14
|
| Rate for Payer: Networks By Design Commercial |
$26.39
|
| Rate for Payer: Networks By Design Commercial |
$15.21
|
| Rate for Payer: Adventist Health Commercial |
$8.21
|
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Blue Shield of California Commercial |
$38.66
|
| Rate for Payer: Blue Shield of California Commercial |
$15.42
|
| Rate for Payer: Blue Shield of California Commercial |
$26.76
|
| Rate for Payer: Blue Shield of California Commercial |
$31.58
|
| Rate for Payer: Blue Shield of California Commercial |
$20.82
|
| Rate for Payer: Blue Shield of California Commercial |
$23.39
|
| Rate for Payer: Blue Shield of California Commercial |
$25.49
|
| Rate for Payer: Blue Shield of California Commercial |
$40.59
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cash Price |
$13.69
|
| Rate for Payer: Cash Price |
$23.75
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cigna of CA HMO |
$35.19
|
| Rate for Payer: Cigna of CA HMO |
$28.74
|
| Rate for Payer: Cigna of CA HMO |
$21.29
|
| Rate for Payer: Cigna of CA HMO |
$36.95
|
| Rate for Payer: Cigna of CA PPO |
$36.95
|
| Rate for Payer: Cigna of CA PPO |
$35.19
|
| Rate for Payer: Cigna of CA PPO |
$21.29
|
| Rate for Payer: Cigna of CA PPO |
$28.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$28.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$35.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$36.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$20.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.11
|
| Rate for Payer: EPIC Health Plan Senior |
$12.17
|
| Rate for Payer: EPIC Health Plan Senior |
$16.42
|
| Rate for Payer: EPIC Health Plan Senior |
$20.11
|
| Rate for Payer: EPIC Health Plan Senior |
$21.11
|
| Rate for Payer: Galaxy Health WC |
$44.86
|
| Rate for Payer: Galaxy Health WC |
$25.86
|
| Rate for Payer: Galaxy Health WC |
$42.73
|
| Rate for Payer: Galaxy Health WC |
$34.90
|
| Rate for Payer: Global Benefits Group Commercial |
$30.16
|
| Rate for Payer: Global Benefits Group Commercial |
$24.64
|
| Rate for Payer: Global Benefits Group Commercial |
$31.67
|
| Rate for Payer: Global Benefits Group Commercial |
$18.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$31.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$26.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$33.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$24.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$31.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.67
|
| Rate for Payer: Multiplan Commercial |
$24.34
|
| Rate for Payer: Multiplan Commercial |
$40.22
|
| Rate for Payer: Prime Health Services Commercial |
$42.73
|
| Rate for Payer: Prime Health Services Commercial |
$25.86
|
| Rate for Payer: Prime Health Services Commercial |
$44.86
|
| Rate for Payer: Prime Health Services Commercial |
$34.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$15.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.81
|
| Rate for Payer: United Healthcare All Other HMO |
$15.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19.28
|
| Rate for Payer: United Healthcare All Other HMO |
$18.36
|
| Rate for Payer: United Healthcare All Other HMO |
$11.11
|
| Rate for Payer: United Healthcare HMO Rider |
$14.67
|
| Rate for Payer: United Healthcare HMO Rider |
$10.87
|
| Rate for Payer: United Healthcare HMO Rider |
$18.86
|
| Rate for Payer: United Healthcare HMO Rider |
$17.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$17.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.46
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION [10578]
|
Facility
|
IP
|
$13.98
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$11.88 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Blue Shield of California Commercial |
$10.75
|
| Rate for Payer: Blue Shield of California Commercial |
$7.09
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cigna of CA HMO |
$9.79
|
| Rate for Payer: Cigna of CA PPO |
$9.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.59
|
| Rate for Payer: EPIC Health Plan Senior |
$5.59
|
| Rate for Payer: Galaxy Health WC |
$11.88
|
| Rate for Payer: Global Benefits Group Commercial |
$8.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: Multiplan Commercial |
$11.18
|
| Rate for Payer: Networks By Design Commercial |
$6.99
|
| Rate for Payer: Prime Health Services Commercial |
$11.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.11
|
| Rate for Payer: United Healthcare HMO Rider |
$5.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.58
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION [10578]
|
Facility
|
OP
|
$13.98
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$11.88 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cigna of CA HMO |
$9.79
|
| Rate for Payer: Cigna of CA PPO |
$9.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.88
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.59
|
| Rate for Payer: EPIC Health Plan Senior |
$5.59
|
| Rate for Payer: Galaxy Health WC |
$11.88
|
| Rate for Payer: Global Benefits Group Commercial |
$8.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.79
|
| Rate for Payer: Multiplan Commercial |
$11.18
|
| Rate for Payer: Networks By Design Commercial |
$6.99
|
| Rate for Payer: Prime Health Services Commercial |
$11.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.39
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.11
|
| Rate for Payer: United Healthcare HMO Rider |
$5.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Vantage Medical Group Senior |
$11.88
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 2 GRAM INTRAVENOUS SOLUTION [10579]
|
Facility
|
IP
|
$130.63
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$26.13 |
| Max. Negotiated Rate |
$111.04 |
| Rate for Payer: Adventist Health Commercial |
$26.13
|
| Rate for Payer: Blue Shield of California Commercial |
$100.45
|
| Rate for Payer: Blue Shield of California Commercial |
$66.23
|
| Rate for Payer: Cash Price |
$58.78
|
| Rate for Payer: Cigna of CA HMO |
$91.44
|
| Rate for Payer: Cigna of CA PPO |
$91.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$91.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.25
|
| Rate for Payer: EPIC Health Plan Senior |
$52.25
|
| Rate for Payer: Galaxy Health WC |
$111.04
|
| Rate for Payer: Global Benefits Group Commercial |
$78.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$82.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.35
|
| Rate for Payer: Multiplan Commercial |
$104.50
|
| Rate for Payer: Networks By Design Commercial |
$65.31
|
| Rate for Payer: Prime Health Services Commercial |
$111.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.03
|
| Rate for Payer: United Healthcare All Other HMO |
$47.72
|
| Rate for Payer: United Healthcare HMO Rider |
$46.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.78
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 2 GRAM INTRAVENOUS SOLUTION [10579]
|
Facility
|
OP
|
$130.63
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$111.04 |
| Rate for Payer: Adventist Health Commercial |
$26.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$111.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$71.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$97.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Cash Price |
$58.78
|
| Rate for Payer: Cash Price |
$58.78
|
| Rate for Payer: Cigna of CA HMO |
$91.44
|
| Rate for Payer: Cigna of CA PPO |
$91.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$111.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$111.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$111.04
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$91.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.25
|
| Rate for Payer: EPIC Health Plan Senior |
$52.25
|
| Rate for Payer: Galaxy Health WC |
$111.04
|
| Rate for Payer: Global Benefits Group Commercial |
$78.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$82.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$77.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$31.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$91.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$91.44
|
| Rate for Payer: Multiplan Commercial |
$104.50
|
| Rate for Payer: Networks By Design Commercial |
$65.31
|
| Rate for Payer: Prime Health Services Commercial |
$111.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$78.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$78.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.03
|
| Rate for Payer: United Healthcare All Other HMO |
$47.72
|
| Rate for Payer: United Healthcare HMO Rider |
$46.69
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$111.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$111.04
|
| Rate for Payer: Vantage Medical Group Senior |
$111.04
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION [10580]
|
Facility
|
IP
|
$7.30
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.46 |
| Max. Negotiated Rate |
$6.21 |
| Rate for Payer: Adventist Health Commercial |
$1.46
|
| Rate for Payer: Blue Shield of California Commercial |
$3.70
|
| Rate for Payer: Blue Shield of California Commercial |
$5.61
|
| Rate for Payer: Cash Price |
$3.28
|
| Rate for Payer: Cigna of CA HMO |
$5.11
|
| Rate for Payer: Cigna of CA PPO |
$5.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.92
|
| Rate for Payer: EPIC Health Plan Senior |
$2.92
|
| Rate for Payer: Galaxy Health WC |
$6.21
|
| Rate for Payer: Global Benefits Group Commercial |
$4.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.75
|
| Rate for Payer: Multiplan Commercial |
$5.84
|
| Rate for Payer: Networks By Design Commercial |
$3.65
|
| Rate for Payer: Prime Health Services Commercial |
$6.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.74
|
| Rate for Payer: United Healthcare All Other HMO |
$2.67
|
| Rate for Payer: United Healthcare HMO Rider |
$2.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.39
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION [10580]
|
Facility
|
OP
|
$7.30
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$8.97 |
| Rate for Payer: Adventist Health Commercial |
$1.46
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Cash Price |
$3.28
|
| Rate for Payer: Cash Price |
$3.28
|
| Rate for Payer: Cigna of CA HMO |
$5.11
|
| Rate for Payer: Cigna of CA PPO |
$5.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.92
|
| Rate for Payer: EPIC Health Plan Senior |
$2.92
|
| Rate for Payer: Galaxy Health WC |
$6.21
|
| Rate for Payer: Global Benefits Group Commercial |
$4.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.11
|
| Rate for Payer: Multiplan Commercial |
$5.84
|
| Rate for Payer: Networks By Design Commercial |
$3.65
|
| Rate for Payer: Prime Health Services Commercial |
$6.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.74
|
| Rate for Payer: United Healthcare All Other HMO |
$2.67
|
| Rate for Payer: United Healthcare HMO Rider |
$2.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.21
|
| Rate for Payer: Vantage Medical Group Senior |
$6.21
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION [10581]
|
Facility
|
IP
|
$26.40
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$22.44 |
| Rate for Payer: Adventist Health Commercial |
$5.28
|
| Rate for Payer: Adventist Health Commercial |
$5.55
|
| Rate for Payer: Adventist Health Commercial |
$5.83
|
| Rate for Payer: Blue Shield of California Commercial |
$21.33
|
| Rate for Payer: Blue Shield of California Commercial |
$13.38
|
| Rate for Payer: Blue Shield of California Commercial |
$20.30
|
| Rate for Payer: Blue Shield of California Commercial |
$22.41
|
| Rate for Payer: Blue Shield of California Commercial |
$14.77
|
| Rate for Payer: Blue Shield of California Commercial |
$14.06
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$12.48
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Cigna of CA HMO |
$20.40
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA HMO |
$18.48
|
| Rate for Payer: Cigna of CA PPO |
$18.48
|
| Rate for Payer: Cigna of CA PPO |
$20.40
|
| Rate for Payer: Cigna of CA PPO |
$19.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Senior |
$11.10
|
| Rate for Payer: EPIC Health Plan Senior |
$10.56
|
| Rate for Payer: EPIC Health Plan Senior |
$11.66
|
| Rate for Payer: Galaxy Health WC |
$24.77
|
| Rate for Payer: Galaxy Health WC |
$22.44
|
| Rate for Payer: Galaxy Health WC |
$23.58
|
| Rate for Payer: Global Benefits Group Commercial |
$16.64
|
| Rate for Payer: Global Benefits Group Commercial |
$15.84
|
| Rate for Payer: Global Benefits Group Commercial |
$17.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$21.12
|
| Rate for Payer: Multiplan Commercial |
$22.19
|
| Rate for Payer: Multiplan Commercial |
$23.31
|
| Rate for Payer: Networks By Design Commercial |
$13.87
|
| Rate for Payer: Networks By Design Commercial |
$14.57
|
| Rate for Payer: Networks By Design Commercial |
$13.20
|
| Rate for Payer: Prime Health Services Commercial |
$22.44
|
| Rate for Payer: Prime Health Services Commercial |
$23.58
|
| Rate for Payer: Prime Health Services Commercial |
$24.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.94
|
| Rate for Payer: United Healthcare All Other HMO |
$10.64
|
| Rate for Payer: United Healthcare All Other HMO |
$9.64
|
| Rate for Payer: United Healthcare All Other HMO |
$10.13
|
| Rate for Payer: United Healthcare HMO Rider |
$9.91
|
| Rate for Payer: United Healthcare HMO Rider |
$10.41
|
| Rate for Payer: United Healthcare HMO Rider |
$9.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.08
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION [10581]
|
Facility
|
OP
|
$27.74
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$23.58 |
| Rate for Payer: Adventist Health Commercial |
$5.55
|
| Rate for Payer: Adventist Health Commercial |
$5.28
|
| Rate for Payer: Adventist Health Commercial |
$5.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.52
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$12.48
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Cash Price |
$12.48
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Cigna of CA HMO |
$20.40
|
| Rate for Payer: Cigna of CA HMO |
$19.42
|
| Rate for Payer: Cigna of CA HMO |
$18.48
|
| Rate for Payer: Cigna of CA PPO |
$18.48
|
| Rate for Payer: Cigna of CA PPO |
$20.40
|
| Rate for Payer: Cigna of CA PPO |
$19.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.77
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$19.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.66
|
| Rate for Payer: EPIC Health Plan Senior |
$11.66
|
| Rate for Payer: EPIC Health Plan Senior |
$10.56
|
| Rate for Payer: EPIC Health Plan Senior |
$11.10
|
| Rate for Payer: Galaxy Health WC |
$23.58
|
| Rate for Payer: Galaxy Health WC |
$24.77
|
| Rate for Payer: Galaxy Health WC |
$22.44
|
| Rate for Payer: Global Benefits Group Commercial |
$16.64
|
| Rate for Payer: Global Benefits Group Commercial |
$15.84
|
| Rate for Payer: Global Benefits Group Commercial |
$17.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.42
|
| Rate for Payer: Multiplan Commercial |
$22.19
|
| Rate for Payer: Multiplan Commercial |
$23.31
|
| Rate for Payer: Multiplan Commercial |
$21.12
|
| Rate for Payer: Networks By Design Commercial |
$14.57
|
| Rate for Payer: Networks By Design Commercial |
$13.87
|
| Rate for Payer: Networks By Design Commercial |
$13.20
|
| Rate for Payer: Prime Health Services Commercial |
$24.77
|
| Rate for Payer: Prime Health Services Commercial |
$22.44
|
| Rate for Payer: Prime Health Services Commercial |
$23.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.91
|
| Rate for Payer: United Healthcare All Other HMO |
$10.64
|
| Rate for Payer: United Healthcare All Other HMO |
$10.13
|
| Rate for Payer: United Healthcare All Other HMO |
$9.64
|
| Rate for Payer: United Healthcare HMO Rider |
$9.44
|
| Rate for Payer: United Healthcare HMO Rider |
$10.41
|
| Rate for Payer: United Healthcare HMO Rider |
$9.91
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.77
|
| Rate for Payer: Vantage Medical Group Senior |
$22.44
|
| Rate for Payer: Vantage Medical Group Senior |
$24.77
|
| Rate for Payer: Vantage Medical Group Senior |
$23.58
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 1,000 MG/8 ML INTRAVENOUS SOLUTION [120963]
|
Facility
|
IP
|
$82.70
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.54 |
| Max. Negotiated Rate |
$70.30 |
| Rate for Payer: Networks By Design Commercial |
$41.35
|
| Rate for Payer: Adventist Health Commercial |
$16.54
|
| Rate for Payer: Blue Shield of California Commercial |
$41.93
|
| Rate for Payer: Blue Shield of California Commercial |
$63.60
|
| Rate for Payer: Cash Price |
$37.22
|
| Rate for Payer: Cigna of CA HMO |
$57.89
|
| Rate for Payer: Cigna of CA PPO |
$57.89
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.08
|
| Rate for Payer: EPIC Health Plan Senior |
$33.08
|
| Rate for Payer: Galaxy Health WC |
$70.30
|
| Rate for Payer: Global Benefits Group Commercial |
$49.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.85
|
| Rate for Payer: Multiplan Commercial |
$66.16
|
| Rate for Payer: Prime Health Services Commercial |
$70.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.04
|
| Rate for Payer: United Healthcare All Other HMO |
$30.21
|
| Rate for Payer: United Healthcare HMO Rider |
$29.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.08
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 1,000 MG/8 ML INTRAVENOUS SOLUTION [120963]
|
Facility
|
OP
|
$82.70
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$70.30 |
| Rate for Payer: Adventist Health Commercial |
$16.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$70.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$62.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Cash Price |
$37.22
|
| Rate for Payer: Cash Price |
$37.22
|
| Rate for Payer: Cigna of CA HMO |
$57.89
|
| Rate for Payer: Cigna of CA PPO |
$57.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$70.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$70.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$70.30
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.08
|
| Rate for Payer: EPIC Health Plan Senior |
$33.08
|
| Rate for Payer: Galaxy Health WC |
$70.30
|
| Rate for Payer: Global Benefits Group Commercial |
$49.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$57.89
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$57.89
|
| Rate for Payer: Multiplan Commercial |
$66.16
|
| Rate for Payer: Networks By Design Commercial |
$41.35
|
| Rate for Payer: Prime Health Services Commercial |
$70.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$31.04
|
| Rate for Payer: United Healthcare All Other HMO |
$30.21
|
| Rate for Payer: United Healthcare HMO Rider |
$29.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$70.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.30
|
| Rate for Payer: Vantage Medical Group Senior |
$70.30
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION [120961]
|
Facility
|
IP
|
$12.50
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.50 |
| Max. Negotiated Rate |
$10.62 |
| Rate for Payer: Adventist Health Commercial |
$2.50
|
| Rate for Payer: Blue Shield of California Commercial |
$6.34
|
| Rate for Payer: Blue Shield of California Commercial |
$9.61
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cigna of CA HMO |
$8.75
|
| Rate for Payer: Cigna of CA PPO |
$8.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5.00
|
| Rate for Payer: Galaxy Health WC |
$10.62
|
| Rate for Payer: Global Benefits Group Commercial |
$7.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Multiplan Commercial |
$10.00
|
| Rate for Payer: Networks By Design Commercial |
$6.25
|
| Rate for Payer: Prime Health Services Commercial |
$10.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.69
|
| Rate for Payer: United Healthcare All Other HMO |
$4.57
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.09
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 125 MG/2 ML SOLUTION FOR INJECTION [120961]
|
Facility
|
OP
|
$12.50
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$10.62 |
| Rate for Payer: Adventist Health Commercial |
$2.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cigna of CA HMO |
$8.75
|
| Rate for Payer: Cigna of CA PPO |
$8.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5.00
|
| Rate for Payer: Galaxy Health WC |
$10.62
|
| Rate for Payer: Global Benefits Group Commercial |
$7.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.75
|
| Rate for Payer: Multiplan Commercial |
$10.00
|
| Rate for Payer: Networks By Design Commercial |
$6.25
|
| Rate for Payer: Prime Health Services Commercial |
$10.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.69
|
| Rate for Payer: United Healthcare All Other HMO |
$4.57
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.62
|
| Rate for Payer: Vantage Medical Group Senior |
$10.62
|
|
