|
ALCOHOLIC LIVER DISEASE
|
Facility
|
IP
|
$33,387.16
|
|
|
Service Code
|
APR-DRG 2804
|
| Min. Negotiated Rate |
$25,611.47 |
| Max. Negotiated Rate |
$33,387.16 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$25,611.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33,387.16
|
|
|
ALCOHOLIC LIVER DISEASE
|
Facility
|
IP
|
$15,874.23
|
|
|
Service Code
|
APR-DRG 2803
|
| Min. Negotiated Rate |
$12,177.21 |
| Max. Negotiated Rate |
$15,874.23 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12,177.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15,874.23
|
|
|
ALCOHOLIC LIVER DISEASE
|
Facility
|
IP
|
$8,079.88
|
|
|
Service Code
|
APR-DRG 2801
|
| Min. Negotiated Rate |
$6,198.12 |
| Max. Negotiated Rate |
$8,079.88 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,198.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,079.88
|
|
|
ALCOHOLIC LIVER DISEASE
|
Facility
|
IP
|
$10,426.17
|
|
|
Service Code
|
APR-DRG 2802
|
| Min. Negotiated Rate |
$7,997.97 |
| Max. Negotiated Rate |
$10,426.17 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7,997.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,426.17
|
|
|
ALECTINIB 150 MG CAPSULE [212384]
|
Facility
|
OP
|
$87.45
|
|
|
Service Code
|
NDC 50242-130-01
|
| Hospital Charge Code |
ERX212384
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$20.99 |
| Max. Negotiated Rate |
$74.33 |
| Rate for Payer: Aetna of CA HMO/PPO |
$57.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$74.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$48.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$52.10
|
| Rate for Payer: Blue Distinction Transplant |
$52.47
|
| Rate for Payer: Blue Shield of California Commercial |
$64.45
|
| Rate for Payer: Blue Shield of California EPN |
$51.07
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Cigna of CA HMO |
$61.22
|
| Rate for Payer: Cigna of CA PPO |
$61.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$74.33
|
| Rate for Payer: Dignity Health Media |
$74.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$74.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$34.98
|
| Rate for Payer: Galaxy Health WC |
$74.33
|
| Rate for Payer: Global Benefits Group Commercial |
$52.47
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$65.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.99
|
| Rate for Payer: Multiplan Commercial |
$69.96
|
| Rate for Payer: Networks By Design Commercial |
$56.84
|
| Rate for Payer: Prime Health Services Commercial |
$74.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$52.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$52.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.72
|
| Rate for Payer: United Healthcare All Other HMO |
$43.72
|
| Rate for Payer: United Healthcare HMO Rider |
$43.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$74.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$74.33
|
| Rate for Payer: Vantage Medical Group Senior |
$74.33
|
|
|
ALECTINIB 150 MG CAPSULE [212384]
|
Facility
|
IP
|
$87.45
|
|
|
Service Code
|
NDC 50242-130-01
|
| Hospital Charge Code |
ERX212384
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$20.99 |
| Max. Negotiated Rate |
$74.33 |
| Rate for Payer: Blue Shield of California Commercial |
$62.26
|
| Rate for Payer: Blue Shield of California EPN |
$44.77
|
| Rate for Payer: Cash Price |
$39.35
|
| Rate for Payer: Cigna of CA HMO |
$61.22
|
| Rate for Payer: Cigna of CA PPO |
$61.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.98
|
| Rate for Payer: Galaxy Health WC |
$74.33
|
| Rate for Payer: Global Benefits Group Commercial |
$52.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$58.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$33.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.99
|
| Rate for Payer: Multiplan Commercial |
$69.96
|
| Rate for Payer: Networks By Design Commercial |
$56.84
|
| Rate for Payer: Prime Health Services Commercial |
$74.33
|
|
|
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION [208005]
|
Facility
|
OP
|
$28,798.18
|
|
|
Service Code
|
CPT J0202
|
| Hospital Charge Code |
NDG208005
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2,324.34 |
| Max. Negotiated Rate |
$24,478.45 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14,618.91
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2,905.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2,556.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2,556.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3,508.09
|
| Rate for Payer: Blue Distinction Transplant |
$17,278.91
|
| Rate for Payer: Blue Shield of California Commercial |
$21,224.26
|
| Rate for Payer: Blue Shield of California EPN |
$2,463.46
|
| Rate for Payer: Cash Price |
$12,959.18
|
| Rate for Payer: Cash Price |
$12,959.18
|
| Rate for Payer: Cigna of CA HMO |
$20,158.73
|
| Rate for Payer: Cigna of CA PPO |
$20,158.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,486.52
|
| Rate for Payer: Dignity Health Media |
$2,324.34
|
| Rate for Payer: Dignity Health Medi-Cal |
$2,556.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,137.86
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,324.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,324.34
|
| Rate for Payer: Galaxy Health WC |
$24,478.45
|
| Rate for Payer: Global Benefits Group Commercial |
$17,278.91
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$21,598.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$3,811.92
|
| Rate for Payer: Heritage Provider Network Transplant |
$3,811.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3,765.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$3,765.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2,324.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,208.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4,424.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,324.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,911.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,928.67
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3,114.62
|
| Rate for Payer: Multiplan Commercial |
$23,038.54
|
| Rate for Payer: Networks By Design Commercial |
$14,399.09
|
| Rate for Payer: Prime Health Services Commercial |
$24,478.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17,278.91
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17,278.91
|
| Rate for Payer: United Healthcare All Other Commercial |
$14,399.09
|
| Rate for Payer: United Healthcare All Other HMO |
$14,399.09
|
| Rate for Payer: United Healthcare HMO Rider |
$14,399.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14,399.09
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,486.52
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,556.78
|
| Rate for Payer: Vantage Medical Group Senior |
$2,324.34
|
|
|
ALEMTUZUMAB 12 MG/1.2 ML INTRAVENOUS SOLUTION [208005]
|
Facility
|
IP
|
$28,798.18
|
|
|
Service Code
|
CPT J0202
|
| Hospital Charge Code |
NDG208005
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6,911.56 |
| Max. Negotiated Rate |
$24,478.45 |
| Rate for Payer: Blue Shield of California Commercial |
$20,504.30
|
| Rate for Payer: Blue Shield of California EPN |
$14,744.67
|
| Rate for Payer: Cash Price |
$12,959.18
|
| Rate for Payer: Cigna of CA HMO |
$20,158.73
|
| Rate for Payer: Cigna of CA PPO |
$20,158.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$11,519.27
|
| Rate for Payer: EPIC Health Plan Transplant |
$11,519.27
|
| Rate for Payer: Galaxy Health WC |
$24,478.45
|
| Rate for Payer: Global Benefits Group Commercial |
$17,278.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19,208.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10,972.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6,911.56
|
| Rate for Payer: Multiplan Commercial |
$23,038.54
|
| Rate for Payer: Networks By Design Commercial |
$14,399.09
|
| Rate for Payer: Prime Health Services Commercial |
$24,478.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,874.19
|
| Rate for Payer: United Healthcare All Other HMO |
$10,620.77
|
| Rate for Payer: United Healthcare HMO Rider |
$10,390.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,503.40
|
|
|
ALENDRONATE 10 MG TABLET [15661]
|
Facility
|
OP
|
$0.24
|
|
|
Service Code
|
NDC 64980-340-03
|
| Hospital Charge Code |
1711759
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.14
|
| Rate for Payer: Blue Distinction Transplant |
$0.14
|
| Rate for Payer: Blue Shield of California Commercial |
$0.18
|
| Rate for Payer: Blue Shield of California EPN |
$0.14
|
| Rate for Payer: Cash Price |
$0.11
|
| Rate for Payer: Cigna of CA HMO |
$0.17
|
| Rate for Payer: Cigna of CA PPO |
$0.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.20
|
| Rate for Payer: Dignity Health Media |
$0.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.20
|
| Rate for Payer: Global Benefits Group Commercial |
$0.14
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.19
|
| Rate for Payer: Networks By Design Commercial |
$0.16
|
| Rate for Payer: Prime Health Services Commercial |
$0.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare HMO Rider |
$0.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.20
|
| Rate for Payer: Vantage Medical Group Senior |
$0.20
|
|
|
ALENDRONATE 10 MG TABLET [15661]
|
Facility
|
IP
|
$0.24
|
|
|
Service Code
|
NDC 64980-340-03
|
| Hospital Charge Code |
1711759
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.20 |
| Rate for Payer: Blue Shield of California Commercial |
$0.17
|
| Rate for Payer: Blue Shield of California EPN |
$0.12
|
| Rate for Payer: Cash Price |
$0.11
|
| Rate for Payer: Cigna of CA HMO |
$0.17
|
| Rate for Payer: Cigna of CA PPO |
$0.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.20
|
| Rate for Payer: Global Benefits Group Commercial |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.19
|
| Rate for Payer: Networks By Design Commercial |
$0.16
|
| Rate for Payer: Prime Health Services Commercial |
$0.20
|
|
|
ALENDRONATE 70 MG/75 ML ORAL SOLUTION [37640]
|
Facility
|
OP
|
$1.10
|
|
|
Service Code
|
NDC 0054-0282-59
|
| Hospital Charge Code |
1715162
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.66
|
| Rate for Payer: Blue Distinction Transplant |
$0.66
|
| Rate for Payer: Blue Shield of California Commercial |
$0.81
|
| Rate for Payer: Blue Shield of California EPN |
$0.64
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna of CA HMO |
$0.77
|
| Rate for Payer: Cigna of CA PPO |
$0.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.94
|
| Rate for Payer: Dignity Health Media |
$0.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.44
|
| Rate for Payer: Galaxy Health WC |
$0.94
|
| Rate for Payer: Global Benefits Group Commercial |
$0.66
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.26
|
| Rate for Payer: Multiplan Commercial |
$0.88
|
| Rate for Payer: Networks By Design Commercial |
$0.72
|
| Rate for Payer: Prime Health Services Commercial |
$0.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.55
|
| Rate for Payer: United Healthcare All Other HMO |
$0.55
|
| Rate for Payer: United Healthcare HMO Rider |
$0.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.94
|
| Rate for Payer: Vantage Medical Group Senior |
$0.94
|
|
|
ALENDRONATE 70 MG/75 ML ORAL SOLUTION [37640]
|
Facility
|
IP
|
$1.10
|
|
|
Service Code
|
NDC 0054-0282-59
|
| Hospital Charge Code |
1715162
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.26 |
| Max. Negotiated Rate |
$0.94 |
| Rate for Payer: Blue Shield of California Commercial |
$0.78
|
| Rate for Payer: Blue Shield of California EPN |
$0.56
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cigna of CA HMO |
$0.77
|
| Rate for Payer: Cigna of CA PPO |
$0.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.44
|
| Rate for Payer: Galaxy Health WC |
$0.94
|
| Rate for Payer: Global Benefits Group Commercial |
$0.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.26
|
| Rate for Payer: Multiplan Commercial |
$0.88
|
| Rate for Payer: Networks By Design Commercial |
$0.72
|
| Rate for Payer: Prime Health Services Commercial |
$0.94
|
|
|
ALENDRONATE 70 MG TABLET [29048]
|
Facility
|
OP
|
$0.75
|
|
|
Service Code
|
NDC 64980-342-14
|
| Hospital Charge Code |
1710931
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.45
|
| Rate for Payer: Blue Distinction Transplant |
$0.45
|
| Rate for Payer: Blue Shield of California Commercial |
$0.55
|
| Rate for Payer: Blue Shield of California EPN |
$0.44
|
| Rate for Payer: Cash Price |
$0.34
|
| Rate for Payer: Cigna of CA HMO |
$0.53
|
| Rate for Payer: Cigna of CA PPO |
$0.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.64
|
| Rate for Payer: Dignity Health Media |
$0.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.30
|
| Rate for Payer: Galaxy Health WC |
$0.64
|
| Rate for Payer: Global Benefits Group Commercial |
$0.45
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.60
|
| Rate for Payer: Networks By Design Commercial |
$0.49
|
| Rate for Payer: Prime Health Services Commercial |
$0.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.38
|
| Rate for Payer: United Healthcare All Other HMO |
$0.38
|
| Rate for Payer: United Healthcare HMO Rider |
$0.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.64
|
| Rate for Payer: Vantage Medical Group Senior |
$0.64
|
|
|
ALENDRONATE 70 MG TABLET [29048]
|
Facility
|
IP
|
$1.65
|
|
|
Service Code
|
NDC 65862-329-04
|
| Hospital Charge Code |
1710931
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$1.40 |
| Rate for Payer: Blue Shield of California Commercial |
$1.17
|
| Rate for Payer: Blue Shield of California EPN |
$0.84
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cigna of CA HMO |
$1.16
|
| Rate for Payer: Cigna of CA PPO |
$1.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: Galaxy Health WC |
$1.40
|
| Rate for Payer: Global Benefits Group Commercial |
$0.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.40
|
| Rate for Payer: Multiplan Commercial |
$1.32
|
| Rate for Payer: Networks By Design Commercial |
$1.07
|
| Rate for Payer: Prime Health Services Commercial |
$1.40
|
|
|
ALENDRONATE 70 MG TABLET [29048]
|
Facility
|
OP
|
$3.35
|
|
|
Service Code
|
NDC 69543-131-20
|
| Hospital Charge Code |
1710931
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$2.85 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.00
|
| Rate for Payer: Blue Distinction Transplant |
$2.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2.47
|
| Rate for Payer: Blue Shield of California EPN |
$1.96
|
| Rate for Payer: Cash Price |
$1.51
|
| Rate for Payer: Cigna of CA HMO |
$2.34
|
| Rate for Payer: Cigna of CA PPO |
$2.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.85
|
| Rate for Payer: Dignity Health Media |
$2.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.34
|
| Rate for Payer: Galaxy Health WC |
$2.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2.01
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$2.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$2.68
|
| Rate for Payer: Networks By Design Commercial |
$2.18
|
| Rate for Payer: Prime Health Services Commercial |
$2.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.68
|
| Rate for Payer: United Healthcare All Other HMO |
$1.68
|
| Rate for Payer: United Healthcare HMO Rider |
$1.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.85
|
| Rate for Payer: Vantage Medical Group Senior |
$2.85
|
|
|
ALENDRONATE 70 MG TABLET [29048]
|
Facility
|
IP
|
$0.75
|
|
|
Service Code
|
NDC 64980-342-14
|
| Hospital Charge Code |
1710931
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.18 |
| Max. Negotiated Rate |
$0.64 |
| Rate for Payer: Blue Shield of California Commercial |
$0.53
|
| Rate for Payer: Blue Shield of California EPN |
$0.38
|
| Rate for Payer: Cash Price |
$0.34
|
| Rate for Payer: Cigna of CA HMO |
$0.53
|
| Rate for Payer: Cigna of CA PPO |
$0.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.30
|
| Rate for Payer: Galaxy Health WC |
$0.64
|
| Rate for Payer: Global Benefits Group Commercial |
$0.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.60
|
| Rate for Payer: Networks By Design Commercial |
$0.49
|
| Rate for Payer: Prime Health Services Commercial |
$0.64
|
|
|
ALENDRONATE 70 MG TABLET [29048]
|
Facility
|
IP
|
$3.35
|
|
|
Service Code
|
NDC 69543-131-20
|
| Hospital Charge Code |
1710931
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$2.85 |
| Rate for Payer: Blue Shield of California Commercial |
$2.39
|
| Rate for Payer: Blue Shield of California EPN |
$1.72
|
| Rate for Payer: Cash Price |
$1.51
|
| Rate for Payer: Cigna of CA HMO |
$2.34
|
| Rate for Payer: Cigna of CA PPO |
$2.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.34
|
| Rate for Payer: Galaxy Health WC |
$2.85
|
| Rate for Payer: Global Benefits Group Commercial |
$2.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.80
|
| Rate for Payer: Multiplan Commercial |
$2.68
|
| Rate for Payer: Networks By Design Commercial |
$2.18
|
| Rate for Payer: Prime Health Services Commercial |
$2.85
|
|
|
ALENDRONATE 70 MG TABLET [29048]
|
Facility
|
OP
|
$1.65
|
|
|
Service Code
|
NDC 65862-329-04
|
| Hospital Charge Code |
1710931
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$1.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.91
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.98
|
| Rate for Payer: Blue Distinction Transplant |
$0.99
|
| Rate for Payer: Blue Shield of California Commercial |
$1.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.96
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cigna of CA HMO |
$1.16
|
| Rate for Payer: Cigna of CA PPO |
$1.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.40
|
| Rate for Payer: Dignity Health Media |
$1.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.66
|
| Rate for Payer: Galaxy Health WC |
$1.40
|
| Rate for Payer: Global Benefits Group Commercial |
$0.99
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.40
|
| Rate for Payer: Multiplan Commercial |
$1.32
|
| Rate for Payer: Networks By Design Commercial |
$1.07
|
| Rate for Payer: Prime Health Services Commercial |
$1.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.83
|
| Rate for Payer: United Healthcare All Other HMO |
$0.83
|
| Rate for Payer: United Healthcare HMO Rider |
$0.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.40
|
| Rate for Payer: Vantage Medical Group Senior |
$1.40
|
|
|
ALFENTANIL 500 MCG/ML INJECTION SOLUTION [25268]
|
Facility
|
IP
|
$4.20
|
|
|
Service Code
|
CPT J0216
|
| Hospital Charge Code |
1737010
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$3.57 |
| Rate for Payer: Blue Shield of California Commercial |
$2.99
|
| Rate for Payer: Blue Shield of California EPN |
$2.15
|
| Rate for Payer: Cash Price |
$1.89
|
| Rate for Payer: Cigna of CA HMO |
$2.94
|
| Rate for Payer: Cigna of CA PPO |
$2.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.68
|
| Rate for Payer: Galaxy Health WC |
$3.57
|
| Rate for Payer: Global Benefits Group Commercial |
$2.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.01
|
| Rate for Payer: Multiplan Commercial |
$3.36
|
| Rate for Payer: Networks By Design Commercial |
$2.10
|
| Rate for Payer: Prime Health Services Commercial |
$3.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.59
|
| Rate for Payer: United Healthcare All Other HMO |
$1.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.39
|
|
|
ALFENTANIL 500 MCG/ML INJECTION SOLUTION [25268]
|
Facility
|
OP
|
$4.20
|
|
|
Service Code
|
CPT J0216
|
| Hospital Charge Code |
1737010
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.01 |
| Max. Negotiated Rate |
$14.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$13.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.31
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.31
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.50
|
| Rate for Payer: Blue Distinction Transplant |
$2.52
|
| Rate for Payer: Blue Shield of California Commercial |
$3.10
|
| Rate for Payer: Blue Shield of California EPN |
$2.45
|
| Rate for Payer: Cash Price |
$1.89
|
| Rate for Payer: Cash Price |
$1.89
|
| Rate for Payer: Cigna of CA HMO |
$2.94
|
| Rate for Payer: Cigna of CA PPO |
$2.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.57
|
| Rate for Payer: Dignity Health Media |
$3.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.68
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.68
|
| Rate for Payer: Galaxy Health WC |
$3.57
|
| Rate for Payer: Global Benefits Group Commercial |
$2.52
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$3.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$14.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.01
|
| Rate for Payer: Multiplan Commercial |
$3.36
|
| Rate for Payer: Networks By Design Commercial |
$2.10
|
| Rate for Payer: Prime Health Services Commercial |
$3.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.10
|
| Rate for Payer: United Healthcare All Other HMO |
$2.10
|
| Rate for Payer: United Healthcare HMO Rider |
$2.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.57
|
| Rate for Payer: Vantage Medical Group Senior |
$3.57
|
|
|
ALFUZOSIN ER 10 MG TABLET,EXTENDED RELEASE 24 HR [36982]
|
Facility
|
IP
|
$0.42
|
|
|
Service Code
|
NDC 47335-956-88
|
| Hospital Charge Code |
1710956
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.10 |
| Max. Negotiated Rate |
$0.36 |
| Rate for Payer: Blue Shield of California Commercial |
$0.30
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Cash Price |
$0.19
|
| Rate for Payer: Cigna of CA HMO |
$0.29
|
| Rate for Payer: Cigna of CA PPO |
$0.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.17
|
| Rate for Payer: Galaxy Health WC |
$0.36
|
| Rate for Payer: Global Benefits Group Commercial |
$0.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.10
|
| Rate for Payer: Multiplan Commercial |
$0.34
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Prime Health Services Commercial |
$0.36
|
|
|
ALFUZOSIN ER 10 MG TABLET,EXTENDED RELEASE 24 HR [36982]
|
Facility
|
OP
|
$0.42
|
|
|
Service Code
|
NDC 47335-956-88
|
| Hospital Charge Code |
1710956
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.10 |
| Max. Negotiated Rate |
$0.36 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.25
|
| Rate for Payer: Blue Distinction Transplant |
$0.25
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.25
|
| Rate for Payer: Cash Price |
$0.19
|
| Rate for Payer: Cigna of CA HMO |
$0.29
|
| Rate for Payer: Cigna of CA PPO |
$0.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.36
|
| Rate for Payer: Dignity Health Media |
$0.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.17
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.17
|
| Rate for Payer: Galaxy Health WC |
$0.36
|
| Rate for Payer: Global Benefits Group Commercial |
$0.25
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.10
|
| Rate for Payer: Multiplan Commercial |
$0.34
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Prime Health Services Commercial |
$0.36
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.21
|
| Rate for Payer: United Healthcare All Other HMO |
$0.21
|
| Rate for Payer: United Healthcare HMO Rider |
$0.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.36
|
| Rate for Payer: Vantage Medical Group Senior |
$0.36
|
|
|
ALFUZOSIN ER 10 MG TABLET,EXTENDED RELEASE 24 HR [36982]
|
Facility
|
OP
|
$0.48
|
|
|
Service Code
|
NDC 13668-021-01
|
| Hospital Charge Code |
1710956
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.41 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.29
|
| Rate for Payer: Blue Distinction Transplant |
$0.29
|
| Rate for Payer: Blue Shield of California Commercial |
$0.35
|
| Rate for Payer: Blue Shield of California EPN |
$0.28
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.34
|
| Rate for Payer: Cigna of CA PPO |
$0.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.41
|
| Rate for Payer: Dignity Health Media |
$0.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.19
|
| Rate for Payer: Galaxy Health WC |
$0.41
|
| Rate for Payer: Global Benefits Group Commercial |
$0.29
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Commercial |
$0.38
|
| Rate for Payer: Networks By Design Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$0.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.24
|
| Rate for Payer: United Healthcare All Other HMO |
$0.24
|
| Rate for Payer: United Healthcare HMO Rider |
$0.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.41
|
| Rate for Payer: Vantage Medical Group Senior |
$0.41
|
|
|
ALFUZOSIN ER 10 MG TABLET,EXTENDED RELEASE 24 HR [36982]
|
Facility
|
IP
|
$0.48
|
|
|
Service Code
|
NDC 13668-021-01
|
| Hospital Charge Code |
1710956
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.41 |
| Rate for Payer: Blue Shield of California Commercial |
$0.34
|
| Rate for Payer: Blue Shield of California EPN |
$0.25
|
| Rate for Payer: Cash Price |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.34
|
| Rate for Payer: Cigna of CA PPO |
$0.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.19
|
| Rate for Payer: Galaxy Health WC |
$0.41
|
| Rate for Payer: Global Benefits Group Commercial |
$0.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Commercial |
$0.38
|
| Rate for Payer: Networks By Design Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$0.41
|
|
|
ALGLUCOSIDASE ALFA 50 MG INTRAVENOUS SOLUTION [76353]
|
Facility
|
OP
|
$1,123.61
|
|
|
Service Code
|
CPT J0221
|
| Hospital Charge Code |
1755758
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$197.28 |
| Max. Negotiated Rate |
$1,240.77 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,240.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$246.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$217.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$217.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$298.41
|
| Rate for Payer: Blue Distinction Transplant |
$674.17
|
| Rate for Payer: Blue Shield of California Commercial |
$828.10
|
| Rate for Payer: Blue Shield of California EPN |
$197.80
|
| Rate for Payer: Cash Price |
$505.62
|
| Rate for Payer: Cash Price |
$505.62
|
| Rate for Payer: Cigna of CA HMO |
$786.53
|
| Rate for Payer: Cigna of CA PPO |
$786.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$295.92
|
| Rate for Payer: Dignity Health Media |
$197.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$217.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$266.33
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$197.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$197.28
|
| Rate for Payer: Galaxy Health WC |
$955.07
|
| Rate for Payer: Global Benefits Group Commercial |
$674.17
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$842.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$323.54
|
| Rate for Payer: Heritage Provider Network Transplant |
$323.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$319.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal Transplant |
$319.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$197.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$749.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$383.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$197.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$269.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$248.57
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$264.35
|
| Rate for Payer: Multiplan Commercial |
$898.89
|
| Rate for Payer: Networks By Design Commercial |
$561.80
|
| Rate for Payer: Prime Health Services Commercial |
$955.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$674.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$674.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$561.80
|
| Rate for Payer: United Healthcare All Other HMO |
$561.80
|
| Rate for Payer: United Healthcare HMO Rider |
$561.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$561.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$295.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$217.01
|
| Rate for Payer: Vantage Medical Group Senior |
$197.28
|
|
