|
CEFOXITIN 10 GRAM INTRAVENOUS SOLUTION (100 MG/ML IVPB) [9462]
|
Facility
|
OP
|
$107.99
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.01 |
| Max. Negotiated Rate |
$91.79 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$70.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$91.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$59.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$80.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.99
|
| Rate for Payer: Blue Shield of California Commercial |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Cash Price |
$59.39
|
| Rate for Payer: Cash Price |
$59.39
|
| Rate for Payer: Cigna of CA HMO |
$75.59
|
| Rate for Payer: Cigna of CA PPO |
$75.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$91.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$91.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$91.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Senior |
$43.20
|
| Rate for Payer: Galaxy Health WC |
$91.79
|
| Rate for Payer: Global Benefits Group Commercial |
$64.79
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75.59
|
| Rate for Payer: Multiplan Commercial |
$86.39
|
| Rate for Payer: Networks By Design Commercial |
$53.99
|
| Rate for Payer: Prime Health Services Commercial |
$91.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$40.53
|
| Rate for Payer: United Healthcare All Other HMO |
$39.45
|
| Rate for Payer: United Healthcare HMO Rider |
$38.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$91.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$91.79
|
| Rate for Payer: Vantage Medical Group Senior |
$91.79
|
|
|
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION [9461]
|
Facility
|
OP
|
$8.39
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$18.99 |
| Rate for Payer: Adventist Health Commercial |
$1.68
|
| Rate for Payer: Adventist Health Commercial |
$1.44
|
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.29
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.99
|
| Rate for Payer: Blue Shield of California Commercial |
$8.39
|
| Rate for Payer: Blue Shield of California Commercial |
$8.39
|
| Rate for Payer: Blue Shield of California Commercial |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Cash Price |
$4.61
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cash Price |
$3.96
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cash Price |
$3.96
|
| Rate for Payer: Cash Price |
$4.61
|
| Rate for Payer: Cigna of CA HMO |
$5.87
|
| Rate for Payer: Cigna of CA HMO |
$8.32
|
| Rate for Payer: Cigna of CA HMO |
$5.04
|
| Rate for Payer: Cigna of CA PPO |
$8.32
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Cigna of CA PPO |
$5.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.36
|
| Rate for Payer: EPIC Health Plan Senior |
$3.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.75
|
| Rate for Payer: EPIC Health Plan Senior |
$2.88
|
| Rate for Payer: Galaxy Health WC |
$6.12
|
| Rate for Payer: Galaxy Health WC |
$7.13
|
| Rate for Payer: Galaxy Health WC |
$10.10
|
| Rate for Payer: Global Benefits Group Commercial |
$4.32
|
| Rate for Payer: Global Benefits Group Commercial |
$7.13
|
| Rate for Payer: Global Benefits Group Commercial |
$5.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.85
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.32
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.04
|
| Rate for Payer: Multiplan Commercial |
$5.76
|
| Rate for Payer: Multiplan Commercial |
$6.71
|
| Rate for Payer: Multiplan Commercial |
$9.50
|
| Rate for Payer: Networks By Design Commercial |
$4.20
|
| Rate for Payer: Networks By Design Commercial |
$3.60
|
| Rate for Payer: Networks By Design Commercial |
$5.94
|
| Rate for Payer: Prime Health Services Commercial |
$7.13
|
| Rate for Payer: Prime Health Services Commercial |
$10.10
|
| Rate for Payer: Prime Health Services Commercial |
$6.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.46
|
| Rate for Payer: United Healthcare All Other HMO |
$3.06
|
| Rate for Payer: United Healthcare All Other HMO |
$2.63
|
| Rate for Payer: United Healthcare All Other HMO |
$4.34
|
| Rate for Payer: United Healthcare HMO Rider |
$4.25
|
| Rate for Payer: United Healthcare HMO Rider |
$3.00
|
| Rate for Payer: United Healthcare HMO Rider |
$2.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$10.10
|
| Rate for Payer: Vantage Medical Group Senior |
$7.13
|
| Rate for Payer: Vantage Medical Group Senior |
$6.12
|
|
|
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION [9461]
|
Facility
|
IP
|
$11.88
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$10.10 |
| Rate for Payer: Blue Shield of California EPN |
$4.08
|
| Rate for Payer: Cash Price |
$3.96
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cash Price |
$4.61
|
| Rate for Payer: Cigna of CA HMO |
$5.04
|
| Rate for Payer: Cigna of CA HMO |
$8.32
|
| Rate for Payer: Cigna of CA HMO |
$5.87
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Cigna of CA PPO |
$8.32
|
| Rate for Payer: Cigna of CA PPO |
$5.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.36
|
| Rate for Payer: EPIC Health Plan Senior |
$3.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.75
|
| Rate for Payer: EPIC Health Plan Senior |
$2.88
|
| Rate for Payer: Galaxy Health WC |
$6.12
|
| Rate for Payer: Galaxy Health WC |
$10.10
|
| Rate for Payer: Galaxy Health WC |
$7.13
|
| Rate for Payer: Global Benefits Group Commercial |
$5.03
|
| Rate for Payer: Global Benefits Group Commercial |
$7.13
|
| Rate for Payer: Global Benefits Group Commercial |
$4.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.74
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.20
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.01
|
| Rate for Payer: Multiplan Commercial |
$9.50
|
| Rate for Payer: Multiplan Commercial |
$5.76
|
| Rate for Payer: Multiplan Commercial |
$6.71
|
| Rate for Payer: Networks By Design Commercial |
$3.60
|
| Rate for Payer: Networks By Design Commercial |
$4.20
|
| Rate for Payer: Networks By Design Commercial |
$5.94
|
| Rate for Payer: Prime Health Services Commercial |
$10.10
|
| Rate for Payer: Prime Health Services Commercial |
$6.12
|
| Rate for Payer: Prime Health Services Commercial |
$7.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.15
|
| Rate for Payer: United Healthcare All Other HMO |
$3.06
|
| Rate for Payer: United Healthcare All Other HMO |
$4.34
|
| Rate for Payer: United Healthcare All Other HMO |
$2.63
|
| Rate for Payer: United Healthcare HMO Rider |
$2.57
|
| Rate for Payer: United Healthcare HMO Rider |
$3.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.36
|
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Adventist Health Commercial |
$1.44
|
| Rate for Payer: Adventist Health Commercial |
$1.68
|
| Rate for Payer: Blue Shield of California Commercial |
$5.31
|
| Rate for Payer: Blue Shield of California Commercial |
$6.19
|
| Rate for Payer: Blue Shield of California Commercial |
$8.77
|
| Rate for Payer: Blue Shield of California EPN |
$3.50
|
| Rate for Payer: Blue Shield of California EPN |
$5.77
|
|
|
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION [9463]
|
Facility
|
IP
|
$12.00
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$10.20 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Adventist Health Commercial |
$3.35
|
| Rate for Payer: Adventist Health Commercial |
$1.92
|
| Rate for Payer: Blue Shield of California Commercial |
$12.36
|
| Rate for Payer: Blue Shield of California Commercial |
$7.08
|
| Rate for Payer: Blue Shield of California Commercial |
$8.86
|
| Rate for Payer: Blue Shield of California EPN |
$8.14
|
| Rate for Payer: Blue Shield of California EPN |
$5.83
|
| Rate for Payer: Blue Shield of California EPN |
$4.67
|
| Rate for Payer: Cash Price |
$9.21
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Cigna of CA HMO |
$11.72
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA HMO |
$6.72
|
| Rate for Payer: Cigna of CA PPO |
$11.72
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$6.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.84
|
| Rate for Payer: EPIC Health Plan Senior |
$3.84
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6.70
|
| Rate for Payer: Galaxy Health WC |
$14.24
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$8.16
|
| Rate for Payer: Global Benefits Group Commercial |
$5.76
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.30
|
| Rate for Payer: Multiplan Commercial |
$9.60
|
| Rate for Payer: Multiplan Commercial |
$13.40
|
| Rate for Payer: Multiplan Commercial |
$7.68
|
| Rate for Payer: Networks By Design Commercial |
$8.38
|
| Rate for Payer: Networks By Design Commercial |
$4.80
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Prime Health Services Commercial |
$14.24
|
| Rate for Payer: Prime Health Services Commercial |
$8.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.60
|
| Rate for Payer: United Healthcare All Other HMO |
$3.51
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare All Other HMO |
$6.12
|
| Rate for Payer: United Healthcare HMO Rider |
$5.99
|
| Rate for Payer: United Healthcare HMO Rider |
$3.43
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.49
|
|
|
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION [9463]
|
Facility
|
OP
|
$9.60
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$18.99 |
| Rate for Payer: Adventist Health Commercial |
$1.92
|
| Rate for Payer: Adventist Health Commercial |
$3.35
|
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.30
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.56
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.99
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18.99
|
| Rate for Payer: Blue Shield of California Commercial |
$8.39
|
| Rate for Payer: Blue Shield of California Commercial |
$8.39
|
| Rate for Payer: Blue Shield of California Commercial |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$9.21
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$9.21
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Cigna of CA HMO |
$6.72
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA HMO |
$11.72
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$11.72
|
| Rate for Payer: Cigna of CA PPO |
$6.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.84
|
| Rate for Payer: EPIC Health Plan Senior |
$3.84
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6.70
|
| Rate for Payer: Galaxy Health WC |
$14.24
|
| Rate for Payer: Galaxy Health WC |
$8.16
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$10.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.72
|
| Rate for Payer: Multiplan Commercial |
$13.40
|
| Rate for Payer: Multiplan Commercial |
$7.68
|
| Rate for Payer: Multiplan Commercial |
$9.60
|
| Rate for Payer: Networks By Design Commercial |
$4.80
|
| Rate for Payer: Networks By Design Commercial |
$8.38
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Prime Health Services Commercial |
$8.16
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Prime Health Services Commercial |
$14.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other HMO |
$3.51
|
| Rate for Payer: United Healthcare All Other HMO |
$6.12
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare HMO Rider |
$3.43
|
| Rate for Payer: United Healthcare HMO Rider |
$5.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.16
|
| Rate for Payer: Vantage Medical Group Senior |
$10.20
|
| Rate for Payer: Vantage Medical Group Senior |
$8.16
|
| Rate for Payer: Vantage Medical Group Senior |
$14.24
|
|
|
CEFPODOXIME 200 MG TABLET [9469]
|
Facility
|
IP
|
$4.48
|
|
|
Service Code
|
NDC 65862-096-20
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Adventist Health Commercial |
$0.90
|
| Rate for Payer: Blue Shield of California Commercial |
$3.31
|
| Rate for Payer: Blue Shield of California EPN |
$2.18
|
| Rate for Payer: Cash Price |
$2.46
|
| Rate for Payer: Cigna of CA HMO |
$3.14
|
| Rate for Payer: Cigna of CA PPO |
$3.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1.79
|
| Rate for Payer: Galaxy Health WC |
$3.81
|
| Rate for Payer: Global Benefits Group Commercial |
$2.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.08
|
| Rate for Payer: Multiplan Commercial |
$3.58
|
| Rate for Payer: Networks By Design Commercial |
$2.91
|
| Rate for Payer: Prime Health Services Commercial |
$3.81
|
|
|
CEFPODOXIME 200 MG TABLET [9469]
|
Facility
|
OP
|
$4.48
|
|
|
Service Code
|
NDC 65862-096-20
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$3.81 |
| Rate for Payer: Adventist Health Commercial |
$0.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.75
|
| Rate for Payer: Cash Price |
$2.46
|
| Rate for Payer: Cigna of CA HMO |
$3.14
|
| Rate for Payer: Cigna of CA PPO |
$3.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1.79
|
| Rate for Payer: Galaxy Health WC |
$3.81
|
| Rate for Payer: Global Benefits Group Commercial |
$2.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.14
|
| Rate for Payer: Multiplan Commercial |
$3.58
|
| Rate for Payer: Networks By Design Commercial |
$2.91
|
| Rate for Payer: Prime Health Services Commercial |
$3.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.24
|
| Rate for Payer: United Healthcare All Other HMO |
$2.24
|
| Rate for Payer: United Healthcare HMO Rider |
$2.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.81
|
| Rate for Payer: Vantage Medical Group Senior |
$3.81
|
|
|
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION [107670]
|
Facility
|
IP
|
$308.95
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.79 |
| Max. Negotiated Rate |
$262.61 |
| Rate for Payer: Adventist Health Commercial |
$61.79
|
| Rate for Payer: Blue Shield of California Commercial |
$228.01
|
| Rate for Payer: Blue Shield of California EPN |
$150.15
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Cigna of CA HMO |
$216.26
|
| Rate for Payer: Cigna of CA PPO |
$216.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.58
|
| Rate for Payer: EPIC Health Plan Senior |
$123.58
|
| Rate for Payer: Galaxy Health WC |
$262.61
|
| Rate for Payer: Global Benefits Group Commercial |
$185.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$206.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$191.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.15
|
| Rate for Payer: Multiplan Commercial |
$247.16
|
| Rate for Payer: Networks By Design Commercial |
$154.47
|
| Rate for Payer: Prime Health Services Commercial |
$262.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.95
|
| Rate for Payer: United Healthcare All Other HMO |
$112.86
|
| Rate for Payer: United Healthcare HMO Rider |
$110.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.18
|
|
|
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION [107670]
|
Facility
|
OP
|
$308.95
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.99 |
| Max. Negotiated Rate |
$262.61 |
| Rate for Payer: Adventist Health Commercial |
$61.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$202.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.58
|
| Rate for Payer: Blue Shield of California Commercial |
$6.13
|
| Rate for Payer: Blue Shield of California EPN |
$6.13
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Cigna of CA HMO |
$216.26
|
| Rate for Payer: Cigna of CA PPO |
$216.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.72
|
| Rate for Payer: EPIC Health Plan Senior |
$4.24
|
| Rate for Payer: Galaxy Health WC |
$262.61
|
| Rate for Payer: Global Benefits Group Commercial |
$185.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$206.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.68
|
| Rate for Payer: Multiplan Commercial |
$247.16
|
| Rate for Payer: Networks By Design Commercial |
$154.47
|
| Rate for Payer: Prime Health Services Commercial |
$262.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$185.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$185.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.95
|
| Rate for Payer: United Healthcare All Other HMO |
$112.86
|
| Rate for Payer: United Healthcare HMO Rider |
$110.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.66
|
| Rate for Payer: Vantage Medical Group Senior |
$4.66
|
|
|
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION [107671]
|
Facility
|
IP
|
$308.95
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.79 |
| Max. Negotiated Rate |
$262.61 |
| Rate for Payer: Adventist Health Commercial |
$61.79
|
| Rate for Payer: Blue Shield of California Commercial |
$228.01
|
| Rate for Payer: Blue Shield of California EPN |
$150.15
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Cigna of CA HMO |
$216.26
|
| Rate for Payer: Cigna of CA PPO |
$216.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.58
|
| Rate for Payer: EPIC Health Plan Senior |
$123.58
|
| Rate for Payer: Galaxy Health WC |
$262.61
|
| Rate for Payer: Global Benefits Group Commercial |
$185.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$206.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$191.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.15
|
| Rate for Payer: Multiplan Commercial |
$247.16
|
| Rate for Payer: Networks By Design Commercial |
$154.47
|
| Rate for Payer: Prime Health Services Commercial |
$262.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.95
|
| Rate for Payer: United Healthcare All Other HMO |
$112.86
|
| Rate for Payer: United Healthcare HMO Rider |
$110.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.18
|
|
|
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION [107671]
|
Facility
|
OP
|
$308.95
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.99 |
| Max. Negotiated Rate |
$262.61 |
| Rate for Payer: Adventist Health Commercial |
$61.79
|
| Rate for Payer: Aetna of CA HMO/PPO |
$202.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$14.58
|
| Rate for Payer: Blue Shield of California Commercial |
$6.13
|
| Rate for Payer: Blue Shield of California EPN |
$6.13
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Cigna of CA HMO |
$216.26
|
| Rate for Payer: Cigna of CA PPO |
$216.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.72
|
| Rate for Payer: EPIC Health Plan Senior |
$4.24
|
| Rate for Payer: Galaxy Health WC |
$262.61
|
| Rate for Payer: Global Benefits Group Commercial |
$185.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$3.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$206.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.68
|
| Rate for Payer: Multiplan Commercial |
$247.16
|
| Rate for Payer: Networks By Design Commercial |
$154.47
|
| Rate for Payer: Prime Health Services Commercial |
$262.61
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$185.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$185.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.95
|
| Rate for Payer: United Healthcare All Other HMO |
$112.86
|
| Rate for Payer: United Healthcare HMO Rider |
$110.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.66
|
| Rate for Payer: Vantage Medical Group Senior |
$4.66
|
|
|
CEFTAZIDIME 10 MG/ML SERIAL DILUTION FOR MIXTURES [4080886]
|
Facility
|
IP
|
$5.12
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$4.35 |
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Blue Shield of California Commercial |
$3.78
|
| Rate for Payer: Blue Shield of California EPN |
$2.49
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cigna of CA HMO |
$3.58
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.05
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| Rate for Payer: Galaxy Health WC |
$4.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.23
|
| Rate for Payer: Multiplan Commercial |
$4.10
|
| Rate for Payer: Networks By Design Commercial |
$2.56
|
| Rate for Payer: Prime Health Services Commercial |
$4.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.87
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.68
|
|
|
CEFTAZIDIME 10 MG/ML SERIAL DILUTION FOR MIXTURES [4080886]
|
Facility
|
OP
|
$5.12
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$5.80 |
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cigna of CA HMO |
$3.58
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.05
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| Rate for Payer: Galaxy Health WC |
$4.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.58
|
| Rate for Payer: Multiplan Commercial |
$4.10
|
| Rate for Payer: Networks By Design Commercial |
$2.56
|
| Rate for Payer: Prime Health Services Commercial |
$4.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.87
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4.35
|
|
|
CEFTAZIDIME 1 GRAM INTRAVENOUS SOLUTION [27290]
|
Facility
|
OP
|
$7.14
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$6.07 |
| Rate for Payer: Adventist Health Commercial |
$1.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.68
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Cigna of CA HMO |
$5.00
|
| Rate for Payer: Cigna of CA PPO |
$5.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.86
|
| Rate for Payer: EPIC Health Plan Senior |
$2.86
|
| Rate for Payer: Galaxy Health WC |
$6.07
|
| Rate for Payer: Global Benefits Group Commercial |
$4.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$5.71
|
| Rate for Payer: Networks By Design Commercial |
$3.57
|
| Rate for Payer: Prime Health Services Commercial |
$6.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.68
|
| Rate for Payer: United Healthcare All Other HMO |
$2.61
|
| Rate for Payer: United Healthcare HMO Rider |
$2.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.07
|
| Rate for Payer: Vantage Medical Group Senior |
$6.07
|
|
|
CEFTAZIDIME 1 GRAM INTRAVENOUS SOLUTION [27290]
|
Facility
|
IP
|
$7.14
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$6.07 |
| Rate for Payer: Adventist Health Commercial |
$1.43
|
| Rate for Payer: Blue Shield of California Commercial |
$5.27
|
| Rate for Payer: Blue Shield of California EPN |
$3.47
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Cigna of CA HMO |
$5.00
|
| Rate for Payer: Cigna of CA PPO |
$5.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.86
|
| Rate for Payer: EPIC Health Plan Senior |
$2.86
|
| Rate for Payer: Galaxy Health WC |
$6.07
|
| Rate for Payer: Global Benefits Group Commercial |
$4.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.71
|
| Rate for Payer: Multiplan Commercial |
$5.71
|
| Rate for Payer: Networks By Design Commercial |
$3.57
|
| Rate for Payer: Prime Health Services Commercial |
$6.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.68
|
| Rate for Payer: United Healthcare All Other HMO |
$2.61
|
| Rate for Payer: United Healthcare HMO Rider |
$2.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.34
|
|
|
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION (200 MG/ML RECONST) [4081895]
|
Facility
|
IP
|
$7.14
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$6.07 |
| Rate for Payer: EPIC Health Plan Commercial |
$2.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.50
|
| Rate for Payer: EPIC Health Plan Senior |
$2.86
|
| Rate for Payer: EPIC Health Plan Senior |
$2.50
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| Rate for Payer: EPIC Health Plan Senior |
$2.16
|
| Rate for Payer: EPIC Health Plan Senior |
$1.56
|
| Rate for Payer: Galaxy Health WC |
$3.32
|
| Rate for Payer: Galaxy Health WC |
$5.30
|
| Rate for Payer: Galaxy Health WC |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$4.59
|
| Rate for Payer: Galaxy Health WC |
$4.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3.07
|
| Rate for Payer: Global Benefits Group Commercial |
$3.24
|
| Rate for Payer: Global Benefits Group Commercial |
$4.28
|
| Rate for Payer: Global Benefits Group Commercial |
$3.74
|
| Rate for Payer: Global Benefits Group Commercial |
$2.35
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.94
|
| Rate for Payer: Multiplan Commercial |
$4.10
|
| Rate for Payer: Multiplan Commercial |
$4.99
|
| Rate for Payer: Multiplan Commercial |
$3.13
|
| Rate for Payer: Multiplan Commercial |
$4.32
|
| Rate for Payer: Multiplan Commercial |
$5.71
|
| Rate for Payer: Networks By Design Commercial |
$3.57
|
| Rate for Payer: Networks By Design Commercial |
$2.70
|
| Rate for Payer: Networks By Design Commercial |
$2.56
|
| Rate for Payer: Networks By Design Commercial |
$3.12
|
| Rate for Payer: Networks By Design Commercial |
$1.96
|
| Rate for Payer: Prime Health Services Commercial |
$6.07
|
| Rate for Payer: Prime Health Services Commercial |
$5.30
|
| Rate for Payer: Prime Health Services Commercial |
$4.59
|
| Rate for Payer: Prime Health Services Commercial |
$4.35
|
| Rate for Payer: Prime Health Services Commercial |
$3.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.03
|
| Rate for Payer: United Healthcare All Other HMO |
$2.61
|
| Rate for Payer: United Healthcare All Other HMO |
$2.28
|
| Rate for Payer: United Healthcare All Other HMO |
$1.87
|
| Rate for Payer: United Healthcare All Other HMO |
$1.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1.97
|
| Rate for Payer: United Healthcare HMO Rider |
$1.40
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$2.55
|
| Rate for Payer: United Healthcare HMO Rider |
$2.23
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.28
|
| Rate for Payer: Adventist Health Commercial |
$1.43
|
| Rate for Payer: Adventist Health Commercial |
$1.08
|
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Adventist Health Commercial |
$0.78
|
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Blue Shield of California Commercial |
$5.27
|
| Rate for Payer: Blue Shield of California Commercial |
$3.99
|
| Rate for Payer: Blue Shield of California Commercial |
$2.89
|
| Rate for Payer: Blue Shield of California Commercial |
$4.61
|
| Rate for Payer: Blue Shield of California Commercial |
$3.78
|
| Rate for Payer: Blue Shield of California EPN |
$1.90
|
| Rate for Payer: Blue Shield of California EPN |
$2.62
|
| Rate for Payer: Blue Shield of California EPN |
$2.49
|
| Rate for Payer: Blue Shield of California EPN |
$3.03
|
| Rate for Payer: Blue Shield of California EPN |
$3.47
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$2.97
|
| Rate for Payer: Cash Price |
$2.15
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cigna of CA HMO |
$4.37
|
| Rate for Payer: Cigna of CA HMO |
$2.74
|
| Rate for Payer: Cigna of CA HMO |
$3.58
|
| Rate for Payer: Cigna of CA HMO |
$3.78
|
| Rate for Payer: Cigna of CA HMO |
$5.00
|
| Rate for Payer: Cigna of CA PPO |
$4.37
|
| Rate for Payer: Cigna of CA PPO |
$3.78
|
| Rate for Payer: Cigna of CA PPO |
$2.74
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: Cigna of CA PPO |
$5.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.56
|
|
|
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION (200 MG/ML RECONST) [4081895]
|
Facility
|
OP
|
$6.24
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$5.80 |
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Adventist Health Commercial |
$1.43
|
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Adventist Health Commercial |
$1.08
|
| Rate for Payer: Adventist Health Commercial |
$0.78
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.59
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.93
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.68
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.84
|
| 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: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$2.97
|
| Rate for Payer: Cash Price |
$2.97
|
| Rate for Payer: Cash Price |
$2.15
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$2.15
|
| Rate for Payer: Cigna of CA HMO |
$2.74
|
| Rate for Payer: Cigna of CA HMO |
$3.58
|
| Rate for Payer: Cigna of CA HMO |
$4.37
|
| Rate for Payer: Cigna of CA HMO |
$3.78
|
| Rate for Payer: Cigna of CA HMO |
$5.00
|
| Rate for Payer: Cigna of CA PPO |
$5.00
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: Cigna of CA PPO |
$2.74
|
| Rate for Payer: Cigna of CA PPO |
$4.37
|
| Rate for Payer: Cigna of CA PPO |
$3.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2.86
|
| Rate for Payer: EPIC Health Plan Senior |
$2.50
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| Rate for Payer: EPIC Health Plan Senior |
$1.56
|
| Rate for Payer: Galaxy Health WC |
$5.30
|
| Rate for Payer: Galaxy Health WC |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$3.32
|
| Rate for Payer: Galaxy Health WC |
$4.35
|
| Rate for Payer: Galaxy Health WC |
$4.59
|
| Rate for Payer: Global Benefits Group Commercial |
$3.07
|
| Rate for Payer: Global Benefits Group Commercial |
$2.35
|
| Rate for Payer: Global Benefits Group Commercial |
$4.28
|
| Rate for Payer: Global Benefits Group Commercial |
$3.24
|
| Rate for Payer: Global Benefits Group Commercial |
$3.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.86
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$4.32
|
| Rate for Payer: Multiplan Commercial |
$5.71
|
| Rate for Payer: Multiplan Commercial |
$4.10
|
| Rate for Payer: Multiplan Commercial |
$3.13
|
| Rate for Payer: Multiplan Commercial |
$4.99
|
| Rate for Payer: Networks By Design Commercial |
$1.96
|
| Rate for Payer: Networks By Design Commercial |
$3.57
|
| Rate for Payer: Networks By Design Commercial |
$2.56
|
| Rate for Payer: Networks By Design Commercial |
$2.70
|
| Rate for Payer: Networks By Design Commercial |
$3.12
|
| Rate for Payer: Prime Health Services Commercial |
$5.30
|
| Rate for Payer: Prime Health Services Commercial |
$4.59
|
| Rate for Payer: Prime Health Services Commercial |
$6.07
|
| Rate for Payer: Prime Health Services Commercial |
$4.35
|
| Rate for Payer: Prime Health Services Commercial |
$3.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.74
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.68
|
| Rate for Payer: United Healthcare All Other HMO |
$2.61
|
| Rate for Payer: United Healthcare All Other HMO |
$2.28
|
| Rate for Payer: United Healthcare All Other HMO |
$1.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1.87
|
| Rate for Payer: United Healthcare All Other HMO |
$1.97
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare HMO Rider |
$2.55
|
| Rate for Payer: United Healthcare HMO Rider |
$1.40
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$2.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.59
|
| Rate for Payer: Vantage Medical Group Senior |
$6.07
|
| Rate for Payer: Vantage Medical Group Senior |
$3.32
|
| Rate for Payer: Vantage Medical Group Senior |
$4.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4.59
|
| Rate for Payer: Vantage Medical Group Senior |
$5.30
|
|
|
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION [9474]
|
Facility
|
OP
|
$5.40
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.08 |
| Max. Negotiated Rate |
$5.80 |
| Rate for Payer: Cash Price |
$2.15
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$2.15
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$2.97
|
| Rate for Payer: Cigna of CA HMO |
$2.74
|
| Rate for Payer: Cigna of CA HMO |
$4.37
|
| Rate for Payer: Cigna of CA HMO |
$3.58
|
| Rate for Payer: Cigna of CA HMO |
$3.78
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: Cigna of CA PPO |
$2.74
|
| Rate for Payer: Cigna of CA PPO |
$3.78
|
| Rate for Payer: Cigna of CA PPO |
$4.37
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2.16
|
| Rate for Payer: EPIC Health Plan Senior |
$1.56
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| Rate for Payer: EPIC Health Plan Senior |
$2.50
|
| Rate for Payer: Galaxy Health WC |
$4.35
|
| Rate for Payer: Galaxy Health WC |
$4.59
|
| Rate for Payer: Galaxy Health WC |
$3.32
|
| Rate for Payer: Galaxy Health WC |
$5.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3.24
|
| Rate for Payer: Global Benefits Group Commercial |
$3.07
|
| Rate for Payer: Global Benefits Group Commercial |
$2.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.58
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.37
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.58
|
| Rate for Payer: Multiplan Commercial |
$3.13
|
| Rate for Payer: Multiplan Commercial |
$4.99
|
| Rate for Payer: Multiplan Commercial |
$4.32
|
| Rate for Payer: Multiplan Commercial |
$4.10
|
| Rate for Payer: Networks By Design Commercial |
$3.12
|
| Rate for Payer: Networks By Design Commercial |
$2.56
|
| Rate for Payer: Networks By Design Commercial |
$2.70
|
| Rate for Payer: Networks By Design Commercial |
$1.96
|
| Rate for Payer: Prime Health Services Commercial |
$4.59
|
| Rate for Payer: Prime Health Services Commercial |
$5.30
|
| Rate for Payer: Prime Health Services Commercial |
$4.35
|
| Rate for Payer: Prime Health Services Commercial |
$3.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.47
|
| Rate for Payer: United Healthcare All Other HMO |
$1.97
|
| Rate for Payer: United Healthcare All Other HMO |
$2.28
|
| Rate for Payer: United Healthcare All Other HMO |
$1.87
|
| Rate for Payer: United Healthcare All Other HMO |
$1.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.23
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.32
|
| Rate for Payer: Vantage Medical Group Senior |
$4.59
|
| Rate for Payer: Vantage Medical Group Senior |
$5.30
|
| Rate for Payer: Vantage Medical Group Senior |
$3.32
|
| Rate for Payer: Vantage Medical Group Senior |
$4.35
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Adventist Health Commercial |
$1.08
|
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Adventist Health Commercial |
$0.78
|
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.54
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.56
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.68
|
| 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: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Cash Price |
$2.97
|
|
|
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION [9474]
|
Facility
|
IP
|
$5.12
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$4.35 |
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Adventist Health Commercial |
$0.78
|
| Rate for Payer: Adventist Health Commercial |
$1.08
|
| Rate for Payer: Blue Shield of California Commercial |
$2.89
|
| Rate for Payer: Blue Shield of California Commercial |
$4.61
|
| Rate for Payer: Blue Shield of California Commercial |
$3.99
|
| Rate for Payer: Blue Shield of California Commercial |
$3.78
|
| Rate for Payer: Blue Shield of California EPN |
$1.90
|
| Rate for Payer: Blue Shield of California EPN |
$2.49
|
| Rate for Payer: Blue Shield of California EPN |
$2.62
|
| Rate for Payer: Blue Shield of California EPN |
$3.03
|
| Rate for Payer: Cash Price |
$2.97
|
| Rate for Payer: Cash Price |
$2.15
|
| Rate for Payer: Cash Price |
$3.43
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cigna of CA HMO |
$2.74
|
| Rate for Payer: Cigna of CA HMO |
$3.78
|
| Rate for Payer: Cigna of CA HMO |
$3.58
|
| Rate for Payer: Cigna of CA HMO |
$4.37
|
| Rate for Payer: Cigna of CA PPO |
$4.37
|
| Rate for Payer: Cigna of CA PPO |
$3.78
|
| Rate for Payer: Cigna of CA PPO |
$2.74
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.50
|
| Rate for Payer: EPIC Health Plan Senior |
$1.56
|
| Rate for Payer: EPIC Health Plan Senior |
$2.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| Rate for Payer: EPIC Health Plan Senior |
$2.50
|
| Rate for Payer: Galaxy Health WC |
$3.32
|
| Rate for Payer: Galaxy Health WC |
$4.35
|
| Rate for Payer: Galaxy Health WC |
$4.59
|
| Rate for Payer: Galaxy Health WC |
$5.30
|
| Rate for Payer: Global Benefits Group Commercial |
$3.74
|
| Rate for Payer: Global Benefits Group Commercial |
$2.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3.24
|
| Rate for Payer: Global Benefits Group Commercial |
$3.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.42
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.49
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.34
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.50
|
| Rate for Payer: Multiplan Commercial |
$3.13
|
| Rate for Payer: Multiplan Commercial |
$4.32
|
| Rate for Payer: Multiplan Commercial |
$4.10
|
| Rate for Payer: Multiplan Commercial |
$4.99
|
| Rate for Payer: Networks By Design Commercial |
$2.56
|
| Rate for Payer: Networks By Design Commercial |
$2.70
|
| Rate for Payer: Networks By Design Commercial |
$3.12
|
| Rate for Payer: Networks By Design Commercial |
$1.96
|
| Rate for Payer: Prime Health Services Commercial |
$4.59
|
| Rate for Payer: Prime Health Services Commercial |
$3.32
|
| Rate for Payer: Prime Health Services Commercial |
$5.30
|
| Rate for Payer: Prime Health Services Commercial |
$4.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.34
|
| Rate for Payer: United Healthcare All Other HMO |
$1.87
|
| Rate for Payer: United Healthcare All Other HMO |
$2.28
|
| Rate for Payer: United Healthcare All Other HMO |
$1.97
|
| Rate for Payer: United Healthcare All Other HMO |
$1.43
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare HMO Rider |
$1.40
|
| Rate for Payer: United Healthcare HMO Rider |
$2.23
|
| Rate for Payer: United Healthcare HMO Rider |
$1.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.77
|
|
|
CEFTAZIDIME 2 GRAM INTRAVENOUS SOLUTION [111787]
|
Facility
|
OP
|
$14.51
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$12.33 |
| Rate for Payer: Adventist Health Commercial |
$2.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.52
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Cash Price |
$7.98
|
| Rate for Payer: Cash Price |
$7.98
|
| Rate for Payer: Cigna of CA HMO |
$10.16
|
| Rate for Payer: Cigna of CA PPO |
$10.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$12.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5.80
|
| Rate for Payer: Galaxy Health WC |
$12.33
|
| Rate for Payer: Global Benefits Group Commercial |
$8.71
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.16
|
| Rate for Payer: Multiplan Commercial |
$11.61
|
| Rate for Payer: Networks By Design Commercial |
$7.25
|
| Rate for Payer: Prime Health Services Commercial |
$12.33
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.45
|
| Rate for Payer: United Healthcare All Other HMO |
$5.30
|
| Rate for Payer: United Healthcare HMO Rider |
$5.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$12.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.33
|
| Rate for Payer: Vantage Medical Group Senior |
$12.33
|
|
|
CEFTAZIDIME 2 GRAM INTRAVENOUS SOLUTION [111787]
|
Facility
|
IP
|
$14.51
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.90 |
| Max. Negotiated Rate |
$12.33 |
| Rate for Payer: Adventist Health Commercial |
$2.90
|
| Rate for Payer: Blue Shield of California Commercial |
$10.71
|
| Rate for Payer: Blue Shield of California EPN |
$7.05
|
| Rate for Payer: Cash Price |
$7.98
|
| Rate for Payer: Cigna of CA HMO |
$10.16
|
| Rate for Payer: Cigna of CA PPO |
$10.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.80
|
| Rate for Payer: EPIC Health Plan Senior |
$5.80
|
| Rate for Payer: Galaxy Health WC |
$12.33
|
| Rate for Payer: Global Benefits Group Commercial |
$8.71
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.98
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.48
|
| Rate for Payer: Multiplan Commercial |
$11.61
|
| Rate for Payer: Networks By Design Commercial |
$7.25
|
| Rate for Payer: Prime Health Services Commercial |
$12.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.45
|
| Rate for Payer: United Healthcare All Other HMO |
$5.30
|
| Rate for Payer: United Healthcare HMO Rider |
$5.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.75
|
|
|
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION [9476]
|
Facility
|
OP
|
$12.00
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$10.20 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Adventist Health Commercial |
$2.64
|
| Rate for Payer: Adventist Health Commercial |
$2.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.52
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.90
|
| 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: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Cash Price |
$7.26
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$7.26
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cigna of CA HMO |
$9.24
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA HMO |
$8.02
|
| Rate for Payer: Cigna of CA PPO |
$8.02
|
| Rate for Payer: Cigna of CA PPO |
$9.24
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4.58
|
| Rate for Payer: EPIC Health Plan Senior |
$5.28
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$11.22
|
| Rate for Payer: Galaxy Health WC |
$9.74
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Global Benefits Group Commercial |
$6.88
|
| Rate for Payer: Global Benefits Group Commercial |
$7.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.02
|
| Rate for Payer: Multiplan Commercial |
$9.60
|
| Rate for Payer: Multiplan Commercial |
$10.56
|
| Rate for Payer: Multiplan Commercial |
$9.17
|
| Rate for Payer: Networks By Design Commercial |
$6.60
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Networks By Design Commercial |
$5.73
|
| Rate for Payer: Prime Health Services Commercial |
$11.22
|
| Rate for Payer: Prime Health Services Commercial |
$9.74
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.95
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.30
|
| Rate for Payer: United Healthcare All Other HMO |
$4.82
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare HMO Rider |
$4.10
|
| Rate for Payer: United Healthcare HMO Rider |
$4.72
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.22
|
| Rate for Payer: Vantage Medical Group Senior |
$9.74
|
| Rate for Payer: Vantage Medical Group Senior |
$11.22
|
| Rate for Payer: Vantage Medical Group Senior |
$10.20
|
|
|
CEFTAZIDIME 2 GRAM SOLUTION FOR INJECTION [9476]
|
Facility
|
IP
|
$11.46
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.29 |
| Max. Negotiated Rate |
$9.74 |
| Rate for Payer: Adventist Health Commercial |
$2.29
|
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Adventist Health Commercial |
$2.64
|
| Rate for Payer: Blue Shield of California Commercial |
$8.86
|
| Rate for Payer: Blue Shield of California Commercial |
$9.74
|
| Rate for Payer: Blue Shield of California Commercial |
$8.46
|
| Rate for Payer: Blue Shield of California EPN |
$5.83
|
| Rate for Payer: Blue Shield of California EPN |
$5.57
|
| Rate for Payer: Blue Shield of California EPN |
$6.42
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.30
|
| Rate for Payer: Cash Price |
$7.26
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA HMO |
$8.02
|
| Rate for Payer: Cigna of CA HMO |
$9.24
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$8.02
|
| Rate for Payer: Cigna of CA PPO |
$9.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
| Rate for Payer: EPIC Health Plan Senior |
$5.28
|
| Rate for Payer: EPIC Health Plan Senior |
$4.58
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$9.74
|
| Rate for Payer: Galaxy Health WC |
$11.22
|
| Rate for Payer: Global Benefits Group Commercial |
$7.92
|
| Rate for Payer: Global Benefits Group Commercial |
$6.88
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.09
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.17
|
| Rate for Payer: Multiplan Commercial |
$9.17
|
| Rate for Payer: Multiplan Commercial |
$9.60
|
| Rate for Payer: Multiplan Commercial |
$10.56
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Networks By Design Commercial |
$6.60
|
| Rate for Payer: Networks By Design Commercial |
$5.73
|
| Rate for Payer: Prime Health Services Commercial |
$9.74
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Prime Health Services Commercial |
$11.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.95
|
| Rate for Payer: United Healthcare All Other HMO |
$4.82
|
| Rate for Payer: United Healthcare All Other HMO |
$4.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare HMO Rider |
$4.72
|
| Rate for Payer: United Healthcare HMO Rider |
$4.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
|
|
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION (100MG/ML IVPB) [9478]
|
Facility
|
IP
|
$28.80
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.76 |
| Max. Negotiated Rate |
$24.48 |
| Rate for Payer: EPIC Health Plan Senior |
$10.41
|
| Rate for Payer: EPIC Health Plan Senior |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$11.52
|
| Rate for Payer: EPIC Health Plan Senior |
$14.67
|
| Rate for Payer: Galaxy Health WC |
$22.13
|
| Rate for Payer: Galaxy Health WC |
$24.48
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Galaxy Health WC |
$31.18
|
| Rate for Payer: Global Benefits Group Commercial |
$22.01
|
| Rate for Payer: Global Benefits Group Commercial |
$15.62
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Global Benefits Group Commercial |
$17.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.80
|
| Rate for Payer: Multiplan Commercial |
$20.82
|
| Rate for Payer: Multiplan Commercial |
$28.00
|
| Rate for Payer: Multiplan Commercial |
$23.04
|
| Rate for Payer: Multiplan Commercial |
$29.34
|
| Rate for Payer: Networks By Design Commercial |
$14.40
|
| Rate for Payer: Networks By Design Commercial |
$17.50
|
| Rate for Payer: Networks By Design Commercial |
$18.34
|
| Rate for Payer: Networks By Design Commercial |
$13.02
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
| Rate for Payer: Prime Health Services Commercial |
$22.13
|
| Rate for Payer: Prime Health Services Commercial |
$31.18
|
| Rate for Payer: Prime Health Services Commercial |
$24.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.77
|
| Rate for Payer: United Healthcare All Other HMO |
$10.52
|
| Rate for Payer: United Healthcare All Other HMO |
$13.40
|
| Rate for Payer: United Healthcare All Other HMO |
$12.79
|
| Rate for Payer: United Healthcare All Other HMO |
$9.51
|
| Rate for Payer: United Healthcare HMO Rider |
$10.29
|
| Rate for Payer: United Healthcare HMO Rider |
$9.30
|
| Rate for Payer: United Healthcare HMO Rider |
$13.11
|
| Rate for Payer: United Healthcare HMO Rider |
$12.51
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.46
|
| Rate for Payer: Adventist Health Commercial |
$5.76
|
| Rate for Payer: Adventist Health Commercial |
$7.34
|
| Rate for Payer: Adventist Health Commercial |
$5.21
|
| Rate for Payer: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Blue Shield of California Commercial |
$19.21
|
| Rate for Payer: Blue Shield of California Commercial |
$27.07
|
| Rate for Payer: Blue Shield of California Commercial |
$25.83
|
| Rate for Payer: Blue Shield of California Commercial |
$21.25
|
| Rate for Payer: Blue Shield of California EPN |
$12.65
|
| Rate for Payer: Blue Shield of California EPN |
$14.00
|
| Rate for Payer: Blue Shield of California EPN |
$17.01
|
| Rate for Payer: Blue Shield of California EPN |
$17.83
|
| Rate for Payer: Cash Price |
$19.25
|
| Rate for Payer: Cash Price |
$14.31
|
| Rate for Payer: Cash Price |
$20.17
|
| Rate for Payer: Cash Price |
$15.84
|
| Rate for Payer: Cigna of CA HMO |
$18.22
|
| Rate for Payer: Cigna of CA HMO |
$24.50
|
| Rate for Payer: Cigna of CA HMO |
$20.16
|
| Rate for Payer: Cigna of CA HMO |
$25.68
|
| Rate for Payer: Cigna of CA PPO |
$25.68
|
| Rate for Payer: Cigna of CA PPO |
$24.50
|
| Rate for Payer: Cigna of CA PPO |
$18.22
|
| Rate for Payer: Cigna of CA PPO |
$20.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.67
|
|
|
CEFTAZIDIME 6 GRAM SOLUTION FOR INJECTION (100MG/ML IVPB) [9478]
|
Facility
|
OP
|
$35.00
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$29.75 |
| Rate for Payer: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Adventist Health Commercial |
$7.34
|
| Rate for Payer: Adventist Health Commercial |
$5.21
|
| Rate for Payer: Adventist Health Commercial |
$5.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$18.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$24.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.52
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$26.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.51
|
| 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: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Cash Price |
$19.25
|
| Rate for Payer: Cash Price |
$15.84
|
| Rate for Payer: Cash Price |
$14.31
|
| Rate for Payer: Cash Price |
$15.84
|
| Rate for Payer: Cash Price |
$14.31
|
| Rate for Payer: Cash Price |
$20.17
|
| Rate for Payer: Cash Price |
$20.17
|
| Rate for Payer: Cash Price |
$19.25
|
| Rate for Payer: Cigna of CA HMO |
$18.22
|
| Rate for Payer: Cigna of CA HMO |
$25.68
|
| Rate for Payer: Cigna of CA HMO |
$20.16
|
| Rate for Payer: Cigna of CA HMO |
$24.50
|
| Rate for Payer: Cigna of CA PPO |
$20.16
|
| Rate for Payer: Cigna of CA PPO |
$18.22
|
| Rate for Payer: Cigna of CA PPO |
$24.50
|
| Rate for Payer: Cigna of CA PPO |
$25.68
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.41
|
| Rate for Payer: EPIC Health Plan Senior |
$11.52
|
| Rate for Payer: EPIC Health Plan Senior |
$14.67
|
| Rate for Payer: Galaxy Health WC |
$24.48
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Galaxy Health WC |
$22.13
|
| Rate for Payer: Galaxy Health WC |
$31.18
|
| Rate for Payer: Global Benefits Group Commercial |
$21.00
|
| Rate for Payer: Global Benefits Group Commercial |
$17.28
|
| Rate for Payer: Global Benefits Group Commercial |
$15.62
|
| Rate for Payer: Global Benefits Group Commercial |
$22.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$17.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$23.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.97
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.98
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$21.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.11
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.83
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$8.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$20.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$24.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.68
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$24.50
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$20.16
|
| Rate for Payer: Multiplan Commercial |
$20.82
|
| Rate for Payer: Multiplan Commercial |
$29.34
|
| Rate for Payer: Multiplan Commercial |
$28.00
|
| Rate for Payer: Multiplan Commercial |
$23.04
|
| Rate for Payer: Networks By Design Commercial |
$18.34
|
| Rate for Payer: Networks By Design Commercial |
$14.40
|
| Rate for Payer: Networks By Design Commercial |
$17.50
|
| Rate for Payer: Networks By Design Commercial |
$13.02
|
| Rate for Payer: Prime Health Services Commercial |
$29.75
|
| Rate for Payer: Prime Health Services Commercial |
$31.18
|
| Rate for Payer: Prime Health Services Commercial |
$24.48
|
| Rate for Payer: Prime Health Services Commercial |
$22.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$22.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$22.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.77
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.77
|
| Rate for Payer: United Healthcare All Other HMO |
$12.79
|
| Rate for Payer: United Healthcare All Other HMO |
$13.40
|
| Rate for Payer: United Healthcare All Other HMO |
$10.52
|
| Rate for Payer: United Healthcare All Other HMO |
$9.51
|
| Rate for Payer: United Healthcare HMO Rider |
$13.11
|
| Rate for Payer: United Healthcare HMO Rider |
$12.51
|
| Rate for Payer: United Healthcare HMO Rider |
$10.29
|
| Rate for Payer: United Healthcare HMO Rider |
$9.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$22.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$29.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$31.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$29.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$31.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.13
|
| Rate for Payer: Vantage Medical Group Senior |
$29.75
|
| Rate for Payer: Vantage Medical Group Senior |
$31.18
|
| Rate for Payer: Vantage Medical Group Senior |
$22.13
|
| Rate for Payer: Vantage Medical Group Senior |
$24.48
|
|
