|
CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION [29567]
|
Facility
IP
|
$82.80
|
|
|
Service Code
|
CPT J0637
|
| Hospital Charge Code |
1759988
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$19.87 |
| Max. Negotiated Rate |
$70.38 |
| Rate for Payer: Blue Shield of California Commercial |
$58.95
|
| Rate for Payer: Blue Shield of California Commercial |
$60.83
|
| Rate for Payer: Blue Shield of California EPN |
$42.39
|
| Rate for Payer: Blue Shield of California EPN |
$43.75
|
| Rate for Payer: Cash Price |
$37.26
|
| Rate for Payer: Cash Price |
$38.45
|
| Rate for Payer: Cigna of CA HMO |
$59.81
|
| Rate for Payer: Cigna of CA HMO |
$57.96
|
| Rate for Payer: Cigna of CA PPO |
$57.96
|
| Rate for Payer: Cigna of CA PPO |
$59.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$33.12
|
| Rate for Payer: EPIC Health Plan Transplant |
$34.18
|
| Rate for Payer: Galaxy Health WC |
$70.38
|
| Rate for Payer: Galaxy Health WC |
$72.62
|
| Rate for Payer: Global Benefits Group Commercial |
$51.26
|
| Rate for Payer: Global Benefits Group Commercial |
$49.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.51
|
| Rate for Payer: Multiplan Commercial |
$68.35
|
| Rate for Payer: Multiplan Commercial |
$66.24
|
| Rate for Payer: Networks By Design Commercial |
$41.40
|
| Rate for Payer: Networks By Design Commercial |
$42.72
|
| Rate for Payer: Prime Health Services Commercial |
$70.38
|
| Rate for Payer: Prime Health Services Commercial |
$72.62
|
|
|
CASPOFUNGIN 50 MG INTRAVENOUS SOLUTION [29567]
|
Facility
OP
|
$82.80
|
|
|
Service Code
|
CPT J0637
|
| Hospital Charge Code |
1759988
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.75 |
| Max. Negotiated Rate |
$70.38 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34.13
|
| Rate for Payer: Aetna of CA HMO/PPO |
$34.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$72.62
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$70.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$45.54
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$46.99
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$45.54
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$46.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.96
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.96
|
| Rate for Payer: BCBS Transplant Transplant |
$49.68
|
| Rate for Payer: BCBS Transplant Transplant |
$51.26
|
| Rate for Payer: Blue Shield of California Commercial |
$61.02
|
| Rate for Payer: Blue Shield of California Commercial |
$62.97
|
| Rate for Payer: Blue Shield of California EPN |
$11.75
|
| Rate for Payer: Blue Shield of California EPN |
$11.75
|
| Rate for Payer: Cash Price |
$38.45
|
| Rate for Payer: Cash Price |
$37.26
|
| Rate for Payer: Cash Price |
$38.45
|
| Rate for Payer: Cash Price |
$37.26
|
| Rate for Payer: Cigna of CA HMO |
$59.81
|
| Rate for Payer: Cigna of CA HMO |
$57.96
|
| Rate for Payer: Cigna of CA PPO |
$57.96
|
| Rate for Payer: Cigna of CA PPO |
$59.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$70.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$72.62
|
| Rate for Payer: Dignity Health Media |
$70.38
|
| Rate for Payer: Dignity Health Media |
$72.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$72.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$70.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$34.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$33.12
|
| Rate for Payer: Galaxy Health WC |
$72.62
|
| Rate for Payer: Galaxy Health WC |
$70.38
|
| Rate for Payer: Global Benefits Group Commercial |
$49.68
|
| Rate for Payer: Global Benefits Group Commercial |
$51.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$62.10
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$64.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$56.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$55.23
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$31.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$20.51
|
| Rate for Payer: Multiplan Commercial |
$68.35
|
| Rate for Payer: Multiplan Commercial |
$66.24
|
| Rate for Payer: Networks By Design Commercial |
$42.72
|
| Rate for Payer: Networks By Design Commercial |
$41.40
|
| Rate for Payer: Prime Health Services Commercial |
$70.38
|
| Rate for Payer: Prime Health Services Commercial |
$72.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$51.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$51.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$41.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$42.72
|
| Rate for Payer: United Healthcare All Other HMO |
$41.40
|
| Rate for Payer: United Healthcare All Other HMO |
$42.72
|
| Rate for Payer: United Healthcare HMO Rider |
$41.40
|
| Rate for Payer: United Healthcare HMO Rider |
$42.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$42.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$70.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$72.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$72.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$70.38
|
| Rate for Payer: Vantage Medical Group Senior |
$72.62
|
| Rate for Payer: Vantage Medical Group Senior |
$70.38
|
|
|
CASPOFUNGIN 70 MG INTRAVENOUS SOLUTION [29568]
|
Facility
IP
|
$118.80
|
|
|
Service Code
|
CPT J0637
|
| Hospital Charge Code |
1759997
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.51 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Blue Shield of California Commercial |
$84.59
|
| Rate for Payer: Blue Shield of California EPN |
$60.83
|
| Rate for Payer: Cash Price |
$53.46
|
| Rate for Payer: Cigna of CA HMO |
$83.16
|
| Rate for Payer: Cigna of CA PPO |
$83.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$47.52
|
| Rate for Payer: Galaxy Health WC |
$100.98
|
| Rate for Payer: Global Benefits Group Commercial |
$71.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.51
|
| Rate for Payer: Multiplan Commercial |
$95.04
|
| Rate for Payer: Networks By Design Commercial |
$59.40
|
| Rate for Payer: Prime Health Services Commercial |
$100.98
|
|
|
CASPOFUNGIN 70 MG INTRAVENOUS SOLUTION [29568]
|
Facility
OP
|
$118.80
|
|
|
Service Code
|
CPT J0637
|
| Hospital Charge Code |
1759997
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.75 |
| Max. Negotiated Rate |
$100.98 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$100.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$65.34
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$65.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$63.96
|
| Rate for Payer: BCBS Transplant Transplant |
$71.28
|
| Rate for Payer: Blue Shield of California Commercial |
$87.56
|
| Rate for Payer: Blue Shield of California EPN |
$11.75
|
| Rate for Payer: Cash Price |
$53.46
|
| Rate for Payer: Cash Price |
$53.46
|
| Rate for Payer: Cigna of CA HMO |
$83.16
|
| Rate for Payer: Cigna of CA PPO |
$83.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$100.98
|
| Rate for Payer: Dignity Health Media |
$100.98
|
| Rate for Payer: Dignity Health Medi-Cal |
$100.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$47.52
|
| Rate for Payer: EPIC Health Plan Transplant |
$47.52
|
| Rate for Payer: Galaxy Health WC |
$100.98
|
| Rate for Payer: Global Benefits Group Commercial |
$71.28
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$89.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$79.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.51
|
| Rate for Payer: Multiplan Commercial |
$95.04
|
| Rate for Payer: Networks By Design Commercial |
$59.40
|
| Rate for Payer: Prime Health Services Commercial |
$100.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$71.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$71.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$59.40
|
| Rate for Payer: United Healthcare All Other HMO |
$59.40
|
| Rate for Payer: United Healthcare HMO Rider |
$59.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$59.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$100.98
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$100.98
|
| Rate for Payer: Vantage Medical Group Senior |
$100.98
|
|
|
CEFACLOR 250 MG/5 ML ORAL SUSPENSION [9434]
|
Facility
IP
|
$1.40
|
|
|
Service Code
|
NDC 16571-071-12
|
| Hospital Charge Code |
NDG9434
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$1.19 |
| Rate for Payer: Blue Shield of California Commercial |
$1.00
|
| Rate for Payer: Blue Shield of California EPN |
$0.72
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cigna of CA HMO |
$0.98
|
| Rate for Payer: Cigna of CA PPO |
$0.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.56
|
| Rate for Payer: Galaxy Health WC |
$1.19
|
| Rate for Payer: Global Benefits Group Commercial |
$0.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: Multiplan Commercial |
$1.12
|
| Rate for Payer: Networks By Design Commercial |
$0.91
|
| Rate for Payer: Prime Health Services Commercial |
$1.19
|
|
|
CEFACLOR 250 MG/5 ML ORAL SUSPENSION [9434]
|
Facility
OP
|
$1.40
|
|
|
Service Code
|
NDC 16571-071-12
|
| Hospital Charge Code |
NDG9434
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$1.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.92
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.77
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: BCBS Transplant Transplant |
$0.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1.03
|
| Rate for Payer: Blue Shield of California EPN |
$0.82
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cigna of CA HMO |
$0.98
|
| Rate for Payer: Cigna of CA PPO |
$0.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.19
|
| Rate for Payer: Dignity Health Media |
$1.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.56
|
| Rate for Payer: Galaxy Health WC |
$1.19
|
| Rate for Payer: Global Benefits Group Commercial |
$0.84
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: Multiplan Commercial |
$1.12
|
| Rate for Payer: Networks By Design Commercial |
$0.91
|
| Rate for Payer: Prime Health Services Commercial |
$1.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.70
|
| Rate for Payer: United Healthcare All Other HMO |
$0.70
|
| Rate for Payer: United Healthcare HMO Rider |
$0.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.19
|
| Rate for Payer: Vantage Medical Group Senior |
$1.19
|
|
|
CEFACLOR 500 MG CAPSULE [9431]
|
Facility
OP
|
$2.86
|
|
|
Service Code
|
NDC 61442-172-30
|
| Hospital Charge Code |
1712040
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.69 |
| Max. Negotiated Rate |
$2.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2.43
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.57
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.70
|
| Rate for Payer: BCBS Transplant Transplant |
$1.72
|
| Rate for Payer: Blue Shield of California Commercial |
$2.11
|
| Rate for Payer: Blue Shield of California EPN |
$1.67
|
| Rate for Payer: Cash Price |
$1.29
|
| Rate for Payer: Cigna of CA HMO |
$2.00
|
| Rate for Payer: Cigna of CA PPO |
$2.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.43
|
| Rate for Payer: Dignity Health Media |
$2.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.14
|
| Rate for Payer: Galaxy Health WC |
$2.43
|
| Rate for Payer: Global Benefits Group Commercial |
$1.72
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.69
|
| Rate for Payer: Multiplan Commercial |
$2.29
|
| Rate for Payer: Networks By Design Commercial |
$1.86
|
| Rate for Payer: Prime Health Services Commercial |
$2.43
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1.43
|
| Rate for Payer: United Healthcare HMO Rider |
$1.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.43
|
| Rate for Payer: Vantage Medical Group Senior |
$2.43
|
|
|
CEFACLOR 500 MG CAPSULE [9431]
|
Facility
IP
|
$2.86
|
|
|
Service Code
|
NDC 61442-172-30
|
| Hospital Charge Code |
1712040
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.69 |
| Max. Negotiated Rate |
$2.43 |
| Rate for Payer: Blue Shield of California Commercial |
$2.04
|
| Rate for Payer: Blue Shield of California EPN |
$1.46
|
| Rate for Payer: Cash Price |
$1.29
|
| Rate for Payer: Cigna of CA HMO |
$2.00
|
| Rate for Payer: Cigna of CA PPO |
$2.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
| Rate for Payer: Galaxy Health WC |
$2.43
|
| Rate for Payer: Global Benefits Group Commercial |
$1.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.69
|
| Rate for Payer: Multiplan Commercial |
$2.29
|
| Rate for Payer: Networks By Design Commercial |
$1.86
|
| Rate for Payer: Prime Health Services Commercial |
$2.43
|
|
|
CEFADROXIL 500 MG CAPSULE [9436]
|
Facility
OP
|
$0.71
|
|
|
Service Code
|
NDC 68180-180-08
|
| Hospital Charge Code |
ERX9436
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.42
|
| Rate for Payer: BCBS Transplant Transplant |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.52
|
| Rate for Payer: Blue Shield of California EPN |
$0.41
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.60
|
| Rate for Payer: Dignity Health Media |
$0.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.60
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.57
|
| Rate for Payer: Networks By Design Commercial |
$0.46
|
| Rate for Payer: Prime Health Services Commercial |
$0.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.36
|
| Rate for Payer: United Healthcare All Other HMO |
$0.36
|
| Rate for Payer: United Healthcare HMO Rider |
$0.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.60
|
| Rate for Payer: Vantage Medical Group Senior |
$0.60
|
|
|
CEFADROXIL 500 MG CAPSULE [9436]
|
Facility
OP
|
$0.71
|
|
|
Service Code
|
NDC 0093-3196-53
|
| Hospital Charge Code |
ERX9436
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.42
|
| Rate for Payer: BCBS Transplant Transplant |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.52
|
| Rate for Payer: Blue Shield of California EPN |
$0.41
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.60
|
| Rate for Payer: Dignity Health Media |
$0.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.60
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.57
|
| Rate for Payer: Networks By Design Commercial |
$0.46
|
| Rate for Payer: Prime Health Services Commercial |
$0.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.36
|
| Rate for Payer: United Healthcare All Other HMO |
$0.36
|
| Rate for Payer: United Healthcare HMO Rider |
$0.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.60
|
| Rate for Payer: Vantage Medical Group Senior |
$0.60
|
|
|
CEFADROXIL 500 MG CAPSULE [9436]
|
Facility
IP
|
$0.71
|
|
|
Service Code
|
NDC 68180-180-08
|
| Hospital Charge Code |
ERX9436
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Blue Shield of California Commercial |
$0.51
|
| Rate for Payer: Blue Shield of California EPN |
$0.36
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.60
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.57
|
| Rate for Payer: Networks By Design Commercial |
$0.46
|
| Rate for Payer: Prime Health Services Commercial |
$0.60
|
|
|
CEFADROXIL 500 MG CAPSULE [9436]
|
Facility
IP
|
$0.71
|
|
|
Service Code
|
NDC 0093-3196-53
|
| Hospital Charge Code |
ERX9436
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Blue Shield of California Commercial |
$0.51
|
| Rate for Payer: Blue Shield of California EPN |
$0.36
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.60
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.57
|
| Rate for Payer: Networks By Design Commercial |
$0.46
|
| Rate for Payer: Prime Health Services Commercial |
$0.60
|
|
|
CEFAZOLIN 10 GRAM SOLUTION FOR INJ (100MG/ML IVPB) [1446]
|
Facility
IP
|
$14.40
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1750334
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.46 |
| Max. Negotiated Rate |
$12.24 |
| Rate for Payer: Blue Shield of California Commercial |
$10.25
|
| Rate for Payer: Blue Shield of California EPN |
$7.37
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Cigna of CA HMO |
$10.08
|
| Rate for Payer: Cigna of CA PPO |
$10.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.76
|
| Rate for Payer: Galaxy Health WC |
$12.24
|
| Rate for Payer: Global Benefits Group Commercial |
$8.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.46
|
| Rate for Payer: Multiplan Commercial |
$11.52
|
| Rate for Payer: Networks By Design Commercial |
$7.20
|
| Rate for Payer: Prime Health Services Commercial |
$12.24
|
|
|
CEFAZOLIN 10 GRAM SOLUTION FOR INJ (100MG/ML IVPB) [1446]
|
Facility
OP
|
$14.40
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1750334
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$12.24 |
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.76
|
| Rate for Payer: Galaxy Health WC |
$12.24
|
| Rate for Payer: Dignity Health Media |
$12.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: BCBS Transplant Transplant |
$8.64
|
| Rate for Payer: Blue Shield of California Commercial |
$10.61
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Cigna of CA HMO |
$10.08
|
| Rate for Payer: Cigna of CA PPO |
$10.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.24
|
| Rate for Payer: Global Benefits Group Commercial |
$8.64
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.46
|
| Rate for Payer: Multiplan Commercial |
$11.52
|
| Rate for Payer: Networks By Design Commercial |
$7.20
|
| Rate for Payer: Prime Health Services Commercial |
$12.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.20
|
| Rate for Payer: United Healthcare All Other HMO |
$7.20
|
| Rate for Payer: United Healthcare HMO Rider |
$7.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.24
|
| Rate for Payer: Vantage Medical Group Senior |
$12.24
|
|
|
CEFAZOLIN 10 MG/ML SERIAL DILUTION FOR MIXTURES [4080885]
|
Facility
IP
|
$1.64
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX4080885
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Blue Shield of California Commercial |
$1.17
|
| Rate for Payer: Blue Shield of California Commercial |
$1.37
|
| Rate for Payer: Blue Shield of California Commercial |
$1.49
|
| Rate for Payer: Blue Shield of California Commercial |
$1.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.98
|
| Rate for Payer: Blue Shield of California EPN |
$1.07
|
| Rate for Payer: Blue Shield of California EPN |
$0.84
|
| Rate for Payer: Blue Shield of California EPN |
$0.88
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cigna of CA HMO |
$1.15
|
| Rate for Payer: Cigna of CA HMO |
$1.46
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.46
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.66
|
| Rate for Payer: Galaxy Health WC |
$1.39
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1.25
|
| Rate for Payer: Global Benefits Group Commercial |
$0.98
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$1.54
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Multiplan Commercial |
$1.31
|
| Rate for Payer: Multiplan Commercial |
$1.38
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Networks By Design Commercial |
$0.82
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Networks By Design Commercial |
$1.04
|
| Rate for Payer: Prime Health Services Commercial |
$1.39
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
|
|
CEFAZOLIN 10 MG/ML SERIAL DILUTION FOR MIXTURES [4080885]
|
Facility
OP
|
$1.64
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX4080885
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$9.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: BCBS Transplant Transplant |
$1.15
|
| Rate for Payer: BCBS Transplant Transplant |
$1.25
|
| Rate for Payer: BCBS Transplant Transplant |
$1.03
|
| Rate for Payer: BCBS Transplant Transplant |
$0.98
|
| Rate for Payer: Blue Shield of California Commercial |
$1.21
|
| Rate for Payer: Blue Shield of California Commercial |
$1.54
|
| Rate for Payer: Blue Shield of California Commercial |
$1.27
|
| Rate for Payer: Blue Shield of California Commercial |
$1.42
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA HMO |
$1.46
|
| Rate for Payer: Cigna of CA HMO |
$1.15
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.46
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.78
|
| Rate for Payer: Dignity Health Media |
$1.39
|
| Rate for Payer: Dignity Health Media |
$1.63
|
| Rate for Payer: Dignity Health Media |
$1.46
|
| Rate for Payer: Dignity Health Media |
$1.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: Galaxy Health WC |
$1.39
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Global Benefits Group Commercial |
$0.98
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.44
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.23
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.57
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.39
|
| Rate for Payer: Multiplan Commercial |
$1.38
|
| Rate for Payer: Multiplan Commercial |
$1.31
|
| Rate for Payer: Multiplan Commercial |
$1.54
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Networks By Design Commercial |
$0.82
|
| Rate for Payer: Networks By Design Commercial |
$1.04
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
| Rate for Payer: Prime Health Services Commercial |
$1.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.86
|
| Rate for Payer: United Healthcare All Other HMO |
$0.86
|
| Rate for Payer: United Healthcare All Other HMO |
$0.96
|
| Rate for Payer: United Healthcare All Other HMO |
$1.04
|
| Rate for Payer: United Healthcare All Other HMO |
$0.82
|
| Rate for Payer: United Healthcare HMO Rider |
$1.04
|
| Rate for Payer: United Healthcare HMO Rider |
$0.86
|
| Rate for Payer: United Healthcare HMO Rider |
$0.96
|
| Rate for Payer: United Healthcare HMO Rider |
$0.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.46
|
| Rate for Payer: Vantage Medical Group Senior |
$1.63
|
| Rate for Payer: Vantage Medical Group Senior |
$1.46
|
| Rate for Payer: Vantage Medical Group Senior |
$1.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1.78
|
|
|
CEFAZOLIN 1 GRAM INJECTION (IM) [4080785]
|
Facility
IP
|
$1.64
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX4080785
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$1.39 |
| Rate for Payer: Blue Shield of California Commercial |
$1.17
|
| Rate for Payer: Blue Shield of California Commercial |
$1.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1.49
|
| Rate for Payer: Blue Shield of California Commercial |
$1.37
|
| Rate for Payer: Blue Shield of California EPN |
$0.84
|
| Rate for Payer: Blue Shield of California EPN |
$0.88
|
| Rate for Payer: Blue Shield of California EPN |
$0.98
|
| Rate for Payer: Blue Shield of California EPN |
$1.07
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$1.15
|
| Rate for Payer: Cigna of CA HMO |
$1.46
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.46
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Galaxy Health WC |
$1.39
|
| Rate for Payer: Global Benefits Group Commercial |
$0.98
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$1.38
|
| Rate for Payer: Multiplan Commercial |
$1.54
|
| Rate for Payer: Multiplan Commercial |
$1.31
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Networks By Design Commercial |
$0.82
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Networks By Design Commercial |
$1.04
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
| Rate for Payer: Prime Health Services Commercial |
$1.39
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
|
|
CEFAZOLIN 1 GRAM INJECTION (IM) [4080785]
|
Facility
OP
|
$1.64
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX4080785
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$9.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: BCBS Transplant Transplant |
$1.25
|
| Rate for Payer: BCBS Transplant Transplant |
$1.15
|
| Rate for Payer: BCBS Transplant Transplant |
$0.98
|
| Rate for Payer: BCBS Transplant Transplant |
$1.03
|
| Rate for Payer: Blue Shield of California Commercial |
$1.21
|
| Rate for Payer: Blue Shield of California Commercial |
$1.42
|
| Rate for Payer: Blue Shield of California Commercial |
$1.54
|
| Rate for Payer: Blue Shield of California Commercial |
$1.27
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$1.15
|
| Rate for Payer: Cigna of CA HMO |
$1.46
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.15
|
| Rate for Payer: Cigna of CA PPO |
$1.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.63
|
| Rate for Payer: Dignity Health Media |
$1.46
|
| Rate for Payer: Dignity Health Media |
$1.78
|
| Rate for Payer: Dignity Health Media |
$1.63
|
| Rate for Payer: Dignity Health Media |
$1.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.84
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Galaxy Health WC |
$1.39
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Global Benefits Group Commercial |
$0.98
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.57
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.29
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.44
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.39
|
| Rate for Payer: Multiplan Commercial |
$1.31
|
| Rate for Payer: Multiplan Commercial |
$1.54
|
| Rate for Payer: Multiplan Commercial |
$1.38
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Networks By Design Commercial |
$1.04
|
| Rate for Payer: Networks By Design Commercial |
$0.82
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Prime Health Services Commercial |
$1.39
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.86
|
| Rate for Payer: United Healthcare All Other HMO |
$0.86
|
| Rate for Payer: United Healthcare All Other HMO |
$0.82
|
| Rate for Payer: United Healthcare All Other HMO |
$0.96
|
| Rate for Payer: United Healthcare All Other HMO |
$1.04
|
| Rate for Payer: United Healthcare HMO Rider |
$0.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1.04
|
| Rate for Payer: United Healthcare HMO Rider |
$0.82
|
| Rate for Payer: United Healthcare HMO Rider |
$0.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.78
|
| Rate for Payer: Vantage Medical Group Senior |
$1.63
|
| Rate for Payer: Vantage Medical Group Senior |
$1.46
|
| Rate for Payer: Vantage Medical Group Senior |
$1.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1.78
|
|
|
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [1445]
|
Facility
OP
|
$1.72
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1720430
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$9.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: BCBS Transplant Transplant |
$1.03
|
| Rate for Payer: Blue Shield of California Commercial |
$1.27
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.46
|
| Rate for Payer: Dignity Health Media |
$1.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$1.38
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.86
|
| Rate for Payer: United Healthcare All Other HMO |
$0.86
|
| Rate for Payer: United Healthcare HMO Rider |
$0.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.46
|
| Rate for Payer: Vantage Medical Group Senior |
$1.46
|
|
|
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [1445]
|
Facility
IP
|
$1.72
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1720430
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$1.46 |
| Rate for Payer: Blue Shield of California Commercial |
$1.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.88
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$1.38
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
|
|
CEFAZOLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK [154193]
|
Facility
IP
|
$17.71
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1753550
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.25 |
| Max. Negotiated Rate |
$15.05 |
| Rate for Payer: Blue Shield of California Commercial |
$12.61
|
| Rate for Payer: Blue Shield of California EPN |
$9.07
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: Cigna of CA HMO |
$12.40
|
| Rate for Payer: Cigna of CA PPO |
$12.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.08
|
| Rate for Payer: Galaxy Health WC |
$15.05
|
| Rate for Payer: Global Benefits Group Commercial |
$10.63
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Multiplan Commercial |
$14.17
|
| Rate for Payer: Networks By Design Commercial |
$8.86
|
| Rate for Payer: Prime Health Services Commercial |
$15.05
|
|
|
CEFAZOLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK [154193]
|
Facility
OP
|
$17.71
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1753550
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$15.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.74
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: BCBS Transplant Transplant |
$10.63
|
| Rate for Payer: Blue Shield of California Commercial |
$13.05
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: Cigna of CA HMO |
$12.40
|
| Rate for Payer: Cigna of CA PPO |
$12.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.05
|
| Rate for Payer: Dignity Health Media |
$15.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.08
|
| Rate for Payer: Galaxy Health WC |
$15.05
|
| Rate for Payer: Global Benefits Group Commercial |
$10.63
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.25
|
| Rate for Payer: Multiplan Commercial |
$14.17
|
| Rate for Payer: Networks By Design Commercial |
$8.86
|
| Rate for Payer: Prime Health Services Commercial |
$15.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.86
|
| Rate for Payer: United Healthcare All Other HMO |
$8.86
|
| Rate for Payer: United Healthcare HMO Rider |
$8.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.86
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
CEFAZOLIN 300 G SOLUTION FOR INJECTION [31087]
|
Facility
OP
|
$366.00
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX31087
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.16 |
| Max. Negotiated Rate |
$311.10 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$311.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$201.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$201.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: BCBS Transplant Transplant |
$219.60
|
| Rate for Payer: Blue Shield of California Commercial |
$269.74
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cigna of CA HMO |
$256.20
|
| Rate for Payer: Cigna of CA PPO |
$256.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$311.10
|
| Rate for Payer: Dignity Health Media |
$311.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$311.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$146.40
|
| Rate for Payer: Galaxy Health WC |
$311.10
|
| Rate for Payer: Global Benefits Group Commercial |
$219.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$274.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$244.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.84
|
| Rate for Payer: Multiplan Commercial |
$292.80
|
| Rate for Payer: Networks By Design Commercial |
$183.00
|
| Rate for Payer: Prime Health Services Commercial |
$311.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$219.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$219.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$183.00
|
| Rate for Payer: United Healthcare All Other HMO |
$183.00
|
| Rate for Payer: United Healthcare HMO Rider |
$183.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$183.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$311.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$311.10
|
| Rate for Payer: Vantage Medical Group Senior |
$311.10
|
|
|
CEFAZOLIN 300 G SOLUTION FOR INJECTION [31087]
|
Facility
IP
|
$366.00
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX31087
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$87.84 |
| Max. Negotiated Rate |
$311.10 |
| Rate for Payer: Blue Shield of California Commercial |
$260.59
|
| Rate for Payer: Blue Shield of California EPN |
$187.39
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cigna of CA HMO |
$256.20
|
| Rate for Payer: Cigna of CA PPO |
$256.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$146.40
|
| Rate for Payer: Galaxy Health WC |
$311.10
|
| Rate for Payer: Global Benefits Group Commercial |
$219.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$244.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$139.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$87.84
|
| Rate for Payer: Multiplan Commercial |
$292.80
|
| Rate for Payer: Networks By Design Commercial |
$183.00
|
| Rate for Payer: Prime Health Services Commercial |
$311.10
|
|
|
CEFAZOLIN 500 MG SOLUTION FOR INJECTION [1448]
|
Facility
OP
|
$1.92
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1720629
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.46 |
| Max. Negotiated Rate |
$9.92 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.43
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: BCBS Transplant Transplant |
$1.15
|
| Rate for Payer: BCBS Transplant Transplant |
$1.01
|
| Rate for Payer: Blue Shield of California Commercial |
$1.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1.42
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$0.76
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.76
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$1.18
|
| Rate for Payer: Cigna of CA PPO |
$1.18
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.63
|
| Rate for Payer: Dignity Health Media |
$1.63
|
| Rate for Payer: Dignity Health Media |
$1.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.67
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Galaxy Health WC |
$1.43
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1.01
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.40
|
| Rate for Payer: Multiplan Commercial |
$1.54
|
| Rate for Payer: Multiplan Commercial |
$1.34
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Networks By Design Commercial |
$0.84
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
| Rate for Payer: Prime Health Services Commercial |
$1.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.96
|
| Rate for Payer: United Healthcare All Other HMO |
$0.96
|
| Rate for Payer: United Healthcare All Other HMO |
$0.84
|
| Rate for Payer: United Healthcare HMO Rider |
$0.84
|
| Rate for Payer: United Healthcare HMO Rider |
$0.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.63
|
| Rate for Payer: Vantage Medical Group Senior |
$1.43
|
| Rate for Payer: Vantage Medical Group Senior |
$1.63
|
|
