|
CEFDINIR 300 MG CAPSULE [22289]
|
Facility
|
IP
|
$1.00
|
|
|
Service Code
|
NDC 5723709960
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.85 |
| Rate for Payer: Adventist Health Commercial |
$0.20
|
| Rate for Payer: Blue Shield of California Commercial |
$0.51
|
| Rate for Payer: Blue Shield of California Commercial |
$0.77
|
| Rate for Payer: Cash Price |
$0.45
|
| Rate for Payer: Cigna of CA HMO |
$0.70
|
| Rate for Payer: Cigna of CA PPO |
$0.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.40
|
| Rate for Payer: EPIC Health Plan Senior |
$0.40
|
| Rate for Payer: Galaxy Health WC |
$0.85
|
| Rate for Payer: Global Benefits Group Commercial |
$0.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.59
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.80
|
| Rate for Payer: Networks By Design Commercial |
$0.65
|
| Rate for Payer: Prime Health Services Commercial |
$0.85
|
|
|
CEFDINIR 300 MG CAPSULE [22289]
|
Facility
|
OP
|
$1.45
|
|
|
Service Code
|
NDC 6800136206
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.29 |
| Max. Negotiated Rate |
$1.23 |
| Rate for Payer: Adventist Health Commercial |
$0.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.93
|
| Rate for Payer: Cash Price |
$0.65
|
| Rate for Payer: Cigna of CA HMO |
$1.01
|
| Rate for Payer: Cigna of CA PPO |
$1.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.58
|
| Rate for Payer: EPIC Health Plan Senior |
$0.58
|
| Rate for Payer: Galaxy Health WC |
$1.23
|
| Rate for Payer: Global Benefits Group Commercial |
$0.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.92
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.01
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.01
|
| Rate for Payer: Multiplan Commercial |
$1.16
|
| Rate for Payer: Networks By Design Commercial |
$0.94
|
| Rate for Payer: Prime Health Services Commercial |
$1.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.73
|
| Rate for Payer: United Healthcare All Other HMO |
$0.73
|
| Rate for Payer: United Healthcare HMO Rider |
$0.73
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.23
|
| Rate for Payer: Vantage Medical Group Senior |
$1.23
|
|
|
CEFDINIR 300 MG CAPSULE [22289]
|
Facility
|
OP
|
$4.05
|
|
|
Service Code
|
NDC 6068769921
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.81 |
| Max. Negotiated Rate |
$3.44 |
| Rate for Payer: Adventist Health Commercial |
$0.81
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.60
|
| Rate for Payer: Cash Price |
$1.82
|
| Rate for Payer: Cigna of CA HMO |
$2.83
|
| Rate for Payer: Cigna of CA PPO |
$2.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1.62
|
| Rate for Payer: Galaxy Health WC |
$3.44
|
| Rate for Payer: Global Benefits Group Commercial |
$2.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.83
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.83
|
| Rate for Payer: Multiplan Commercial |
$3.24
|
| Rate for Payer: Networks By Design Commercial |
$2.63
|
| Rate for Payer: Prime Health Services Commercial |
$3.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.02
|
| Rate for Payer: United Healthcare All Other HMO |
$2.02
|
| Rate for Payer: United Healthcare HMO Rider |
$2.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.44
|
| Rate for Payer: Vantage Medical Group Senior |
$3.44
|
|
|
CEFDINIR 300 MG CAPSULE [22289]
|
Facility
|
IP
|
$4.05
|
|
|
Service Code
|
NDC 6068769921
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.81 |
| Max. Negotiated Rate |
$3.44 |
| Rate for Payer: Adventist Health Commercial |
$0.81
|
| Rate for Payer: Blue Shield of California Commercial |
$2.05
|
| Rate for Payer: Blue Shield of California Commercial |
$3.11
|
| Rate for Payer: Cash Price |
$1.82
|
| Rate for Payer: Cigna of CA HMO |
$2.83
|
| Rate for Payer: Cigna of CA PPO |
$2.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.62
|
| Rate for Payer: EPIC Health Plan Senior |
$1.62
|
| Rate for Payer: Galaxy Health WC |
$3.44
|
| Rate for Payer: Global Benefits Group Commercial |
$2.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.97
|
| Rate for Payer: Multiplan Commercial |
$3.24
|
| Rate for Payer: Networks By Design Commercial |
$2.63
|
| Rate for Payer: Prime Health Services Commercial |
$3.44
|
|
|
CEFEPIME 100 GRAM INTRAVENOUS SOLUTION [223402]
|
Facility
|
OP
|
$540.00
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.30 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: EPIC Health Plan Senior |
$216.00
|
| Rate for Payer: Galaxy Health WC |
$459.00
|
| Rate for Payer: Adventist Health Commercial |
$108.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$459.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$297.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$405.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cigna of CA HMO |
$378.00
|
| Rate for Payer: Cigna of CA PPO |
$378.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$459.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$459.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$459.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$378.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$216.00
|
| Rate for Payer: Global Benefits Group Commercial |
$324.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$342.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$196.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$318.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$378.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$378.00
|
| Rate for Payer: Multiplan Commercial |
$432.00
|
| Rate for Payer: Networks By Design Commercial |
$270.00
|
| Rate for Payer: Prime Health Services Commercial |
$459.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$324.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$324.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$202.66
|
| Rate for Payer: United Healthcare All Other HMO |
$197.26
|
| Rate for Payer: United Healthcare HMO Rider |
$193.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$176.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$459.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$459.00
|
| Rate for Payer: Vantage Medical Group Senior |
$459.00
|
|
|
CEFEPIME 100 GRAM INTRAVENOUS SOLUTION [223402]
|
Facility
|
IP
|
$540.00
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$108.00 |
| Max. Negotiated Rate |
$459.00 |
| Rate for Payer: Adventist Health Commercial |
$108.00
|
| Rate for Payer: Blue Shield of California Commercial |
$273.78
|
| Rate for Payer: Blue Shield of California Commercial |
$415.26
|
| Rate for Payer: Cash Price |
$243.00
|
| Rate for Payer: Cigna of CA HMO |
$378.00
|
| Rate for Payer: Cigna of CA PPO |
$378.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$378.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$216.00
|
| Rate for Payer: EPIC Health Plan Senior |
$216.00
|
| Rate for Payer: Galaxy Health WC |
$459.00
|
| Rate for Payer: Global Benefits Group Commercial |
$324.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$342.90
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$318.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$129.60
|
| Rate for Payer: Multiplan Commercial |
$432.00
|
| Rate for Payer: Networks By Design Commercial |
$270.00
|
| Rate for Payer: Prime Health Services Commercial |
$459.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$202.66
|
| Rate for Payer: United Healthcare All Other HMO |
$197.26
|
| Rate for Payer: United Healthcare HMO Rider |
$193.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$176.85
|
|
|
CEFEPIME 1 GRAM IM INJECTION (PEDS) [40816369]
|
Facility
|
IP
|
$5.22
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.04 |
| Max. Negotiated Rate |
$4.44 |
| Rate for Payer: Adventist Health Commercial |
$1.04
|
| Rate for Payer: Blue Shield of California Commercial |
$2.65
|
| Rate for Payer: Blue Shield of California Commercial |
$4.01
|
| Rate for Payer: Cash Price |
$2.35
|
| Rate for Payer: Cigna of CA HMO |
$3.65
|
| Rate for Payer: Cigna of CA PPO |
$3.65
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.09
|
| Rate for Payer: EPIC Health Plan Senior |
$2.09
|
| Rate for Payer: Galaxy Health WC |
$4.44
|
| Rate for Payer: Global Benefits Group Commercial |
$3.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.25
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$2.61
|
| Rate for Payer: Prime Health Services Commercial |
$4.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.96
|
| Rate for Payer: United Healthcare All Other HMO |
$1.91
|
| Rate for Payer: United Healthcare HMO Rider |
$1.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.71
|
|
|
CEFEPIME 1 GRAM IM INJECTION (PEDS) [40816369]
|
Facility
|
OP
|
$5.22
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.04 |
| Max. Negotiated Rate |
$19.04 |
| Rate for Payer: Adventist Health Commercial |
$1.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.44
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Cash Price |
$2.35
|
| Rate for Payer: Cash Price |
$2.35
|
| Rate for Payer: Cigna of CA HMO |
$3.65
|
| Rate for Payer: Cigna of CA PPO |
$3.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.09
|
| Rate for Payer: EPIC Health Plan Senior |
$2.09
|
| Rate for Payer: Galaxy Health WC |
$4.44
|
| Rate for Payer: Global Benefits Group Commercial |
$3.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.65
|
| Rate for Payer: Multiplan Commercial |
$4.18
|
| Rate for Payer: Networks By Design Commercial |
$2.61
|
| Rate for Payer: Prime Health Services Commercial |
$4.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.96
|
| Rate for Payer: United Healthcare All Other HMO |
$1.91
|
| Rate for Payer: United Healthcare HMO Rider |
$1.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.44
|
| Rate for Payer: Vantage Medical Group Senior |
$4.44
|
|
|
CEFEPIME 1 GRAM SOLUTION FOR INJECTION [16369]
|
Facility
|
OP
|
$6.06
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$19.04 |
| Rate for Payer: Galaxy Health WC |
$5.15
|
| Rate for Payer: Galaxy Health WC |
$5.14
|
| Rate for Payer: EPIC Health Plan Senior |
$2.42
|
| Rate for Payer: Adventist Health Commercial |
$1.21
|
| Rate for Payer: Adventist Health Commercial |
$1.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Cash Price |
$2.72
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: Cash Price |
$2.72
|
| Rate for Payer: Cigna of CA HMO |
$4.24
|
| Rate for Payer: Cigna of CA HMO |
$4.24
|
| Rate for Payer: Cigna of CA PPO |
$4.24
|
| Rate for Payer: Cigna of CA PPO |
$4.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.42
|
| Rate for Payer: EPIC Health Plan Senior |
$2.42
|
| Rate for Payer: Global Benefits Group Commercial |
$3.64
|
| Rate for Payer: Global Benefits Group Commercial |
$3.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.24
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.24
|
| Rate for Payer: Multiplan Commercial |
$4.85
|
| Rate for Payer: Multiplan Commercial |
$4.84
|
| Rate for Payer: Networks By Design Commercial |
$3.03
|
| Rate for Payer: Networks By Design Commercial |
$3.02
|
| Rate for Payer: Prime Health Services Commercial |
$5.14
|
| Rate for Payer: Prime Health Services Commercial |
$5.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.27
|
| Rate for Payer: United Healthcare All Other HMO |
$2.21
|
| Rate for Payer: United Healthcare All Other HMO |
$2.21
|
| Rate for Payer: United Healthcare HMO Rider |
$2.17
|
| Rate for Payer: United Healthcare HMO Rider |
$2.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.15
|
| Rate for Payer: Vantage Medical Group Senior |
$5.14
|
| Rate for Payer: Vantage Medical Group Senior |
$5.15
|
|
|
CEFEPIME 1 GRAM SOLUTION FOR INJECTION [16369]
|
Facility
|
IP
|
$6.06
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.21 |
| Max. Negotiated Rate |
$5.15 |
| Rate for Payer: Adventist Health Commercial |
$1.21
|
| Rate for Payer: Adventist Health Commercial |
$1.21
|
| Rate for Payer: Blue Shield of California Commercial |
$4.65
|
| Rate for Payer: Blue Shield of California Commercial |
$3.07
|
| Rate for Payer: Blue Shield of California Commercial |
$4.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3.07
|
| Rate for Payer: Cash Price |
$2.72
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: Cigna of CA HMO |
$4.24
|
| Rate for Payer: Cigna of CA HMO |
$4.24
|
| Rate for Payer: Cigna of CA PPO |
$4.24
|
| Rate for Payer: Cigna of CA PPO |
$4.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.42
|
| Rate for Payer: EPIC Health Plan Senior |
$2.42
|
| Rate for Payer: EPIC Health Plan Senior |
$2.42
|
| Rate for Payer: Galaxy Health WC |
$5.14
|
| Rate for Payer: Galaxy Health WC |
$5.15
|
| Rate for Payer: Global Benefits Group Commercial |
$3.64
|
| Rate for Payer: Global Benefits Group Commercial |
$3.63
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: Multiplan Commercial |
$4.84
|
| Rate for Payer: Multiplan Commercial |
$4.85
|
| Rate for Payer: Networks By Design Commercial |
$3.03
|
| Rate for Payer: Networks By Design Commercial |
$3.02
|
| Rate for Payer: Prime Health Services Commercial |
$5.15
|
| Rate for Payer: Prime Health Services Commercial |
$5.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.27
|
| Rate for Payer: United Healthcare All Other HMO |
$2.21
|
| Rate for Payer: United Healthcare All Other HMO |
$2.21
|
| Rate for Payer: United Healthcare HMO Rider |
$2.16
|
| Rate for Payer: United Healthcare HMO Rider |
$2.17
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.98
|
|
|
CEFEPIME 2 GRAM SOLUTION FOR INJECTION (100 MG/ML IVPB) [16371]
|
Facility
|
IP
|
$6.00
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$5.10 |
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.20
|
| 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 |
$2.40
|
| Rate for Payer: EPIC Health Plan Senior |
$3.53
|
| Rate for Payer: EPIC Health Plan Senior |
$5.20
|
| Rate for Payer: EPIC Health Plan Senior |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$10.25
|
| Rate for Payer: Galaxy Health WC |
$11.06
|
| Rate for Payer: Galaxy Health WC |
$7.50
|
| Rate for Payer: Galaxy Health WC |
$5.10
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Adventist Health Commercial |
$1.20
|
| Rate for Payer: Adventist Health Commercial |
$2.41
|
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Adventist Health Commercial |
$2.60
|
| Rate for Payer: Adventist Health Commercial |
$1.76
|
| Rate for Payer: Blue Shield of California Commercial |
$9.27
|
| Rate for Payer: Blue Shield of California Commercial |
$6.11
|
| Rate for Payer: Blue Shield of California Commercial |
$9.23
|
| Rate for Payer: Blue Shield of California Commercial |
$10.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4.47
|
| Rate for Payer: Blue Shield of California Commercial |
$6.78
|
| Rate for Payer: Blue Shield of California Commercial |
$6.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4.61
|
| Rate for Payer: Blue Shield of California Commercial |
$6.08
|
| Rate for Payer: Blue Shield of California Commercial |
$3.04
|
| Rate for Payer: Cash Price |
$3.97
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.43
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cigna of CA HMO |
$4.20
|
| Rate for Payer: Cigna of CA HMO |
$9.11
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA HMO |
$8.44
|
| Rate for Payer: Cigna of CA HMO |
$6.17
|
| Rate for Payer: Cigna of CA PPO |
$4.20
|
| Rate for Payer: Cigna of CA PPO |
$9.11
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$8.44
|
| Rate for Payer: Cigna of CA PPO |
$6.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.40
|
| Rate for Payer: Global Benefits Group Commercial |
$7.81
|
| Rate for Payer: Global Benefits Group Commercial |
$7.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5.29
|
| Rate for Payer: Global Benefits Group Commercial |
$3.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: Multiplan Commercial |
$9.65
|
| Rate for Payer: Multiplan Commercial |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$9.60
|
| Rate for Payer: Multiplan Commercial |
$10.41
|
| Rate for Payer: Multiplan Commercial |
$7.06
|
| Rate for Payer: Networks By Design Commercial |
$4.41
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: Networks By Design Commercial |
$6.03
|
| Rate for Payer: Networks By Design Commercial |
$3.00
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Prime Health Services Commercial |
$7.50
|
| Rate for Payer: Prime Health Services Commercial |
$5.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.06
|
| Rate for Payer: Prime Health Services Commercial |
$10.25
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.88
|
| Rate for Payer: United Healthcare All Other HMO |
$3.22
|
| Rate for Payer: United Healthcare All Other HMO |
$2.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.41
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare All Other HMO |
$4.75
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$3.15
|
| Rate for Payer: United Healthcare HMO Rider |
$2.14
|
| Rate for Payer: United Healthcare HMO Rider |
$4.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
|
|
CEFEPIME 2 GRAM SOLUTION FOR INJECTION (100 MG/ML IVPB) [16371]
|
Facility
|
OP
|
$12.06
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.30 |
| Max. Negotiated Rate |
$19.04 |
| Rate for Payer: Adventist Health Commercial |
$2.41
|
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Adventist Health Commercial |
$2.60
|
| Rate for Payer: Adventist Health Commercial |
$1.20
|
| Rate for Payer: Adventist Health Commercial |
$1.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Cash Price |
$3.97
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$5.85
|
| Rate for Payer: Cash Price |
$2.70
|
| Rate for Payer: Cash Price |
$3.97
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.43
|
| Rate for Payer: Cash Price |
$5.43
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna of CA HMO |
$4.20
|
| Rate for Payer: Cigna of CA HMO |
$8.44
|
| Rate for Payer: Cigna of CA HMO |
$9.11
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA HMO |
$6.17
|
| Rate for Payer: Cigna of CA PPO |
$9.11
|
| Rate for Payer: Cigna of CA PPO |
$4.20
|
| Rate for Payer: Cigna of CA PPO |
$8.44
|
| Rate for Payer: Cigna of CA PPO |
$6.17
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.20
|
| Rate for Payer: EPIC Health Plan Senior |
$5.20
|
| Rate for Payer: EPIC Health Plan Senior |
$3.53
|
| Rate for Payer: EPIC Health Plan Senior |
$2.40
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4.82
|
| Rate for Payer: Galaxy Health WC |
$5.10
|
| Rate for Payer: Galaxy Health WC |
$7.50
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$10.25
|
| Rate for Payer: Galaxy Health WC |
$11.06
|
| Rate for Payer: Global Benefits Group Commercial |
$7.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5.29
|
| Rate for Payer: Global Benefits Group Commercial |
$7.81
|
| Rate for Payer: Global Benefits Group Commercial |
$3.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.44
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.17
|
| Rate for Payer: Multiplan Commercial |
$10.41
|
| Rate for Payer: Multiplan Commercial |
$7.06
|
| Rate for Payer: Multiplan Commercial |
$9.65
|
| Rate for Payer: Multiplan Commercial |
$9.60
|
| Rate for Payer: Multiplan Commercial |
$4.80
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Networks By Design Commercial |
$4.41
|
| Rate for Payer: Networks By Design Commercial |
$6.03
|
| Rate for Payer: Networks By Design Commercial |
$6.50
|
| Rate for Payer: Networks By Design Commercial |
$3.00
|
| Rate for Payer: Prime Health Services Commercial |
$5.10
|
| Rate for Payer: Prime Health Services Commercial |
$11.06
|
| Rate for Payer: Prime Health Services Commercial |
$7.50
|
| Rate for Payer: Prime Health Services Commercial |
$10.25
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.31
|
| Rate for Payer: United Healthcare All Other HMO |
$3.22
|
| Rate for Payer: United Healthcare All Other HMO |
$2.19
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare All Other HMO |
$4.41
|
| Rate for Payer: United Healthcare All Other HMO |
$4.75
|
| Rate for Payer: United Healthcare HMO Rider |
$4.31
|
| Rate for Payer: United Healthcare HMO Rider |
$3.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare HMO Rider |
$4.65
|
| Rate for Payer: United Healthcare HMO Rider |
$2.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.06
|
| Rate for Payer: Vantage Medical Group Senior |
$7.50
|
| Rate for Payer: Vantage Medical Group Senior |
$10.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10.25
|
| Rate for Payer: Vantage Medical Group Senior |
$11.06
|
| Rate for Payer: Vantage Medical Group Senior |
$5.10
|
|
|
CEFEPIME (MAXIPIME) 1G/10ML FROZEN SYRINGE [4081917]
|
Facility
|
IP
|
$0.54
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.46 |
| Rate for Payer: Adventist Health Commercial |
$0.11
|
| Rate for Payer: Adventist Health Commercial |
$0.09
|
| Rate for Payer: Blue Shield of California Commercial |
$0.34
|
| Rate for Payer: Blue Shield of California Commercial |
$0.27
|
| Rate for Payer: Blue Shield of California Commercial |
$0.42
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: Cigna of CA HMO |
$0.38
|
| Rate for Payer: Cigna of CA HMO |
$0.31
|
| Rate for Payer: Cigna of CA PPO |
$0.31
|
| Rate for Payer: Cigna of CA PPO |
$0.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.18
|
| Rate for Payer: EPIC Health Plan Senior |
$0.22
|
| Rate for Payer: Galaxy Health WC |
$0.37
|
| Rate for Payer: Galaxy Health WC |
$0.46
|
| Rate for Payer: Global Benefits Group Commercial |
$0.32
|
| Rate for Payer: Global Benefits Group Commercial |
$0.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
| Rate for Payer: Multiplan Commercial |
$0.35
|
| Rate for Payer: Multiplan Commercial |
$0.43
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Networks By Design Commercial |
$0.22
|
| Rate for Payer: Prime Health Services Commercial |
$0.46
|
| Rate for Payer: Prime Health Services Commercial |
$0.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO |
$0.16
|
| Rate for Payer: United Healthcare HMO Rider |
$0.16
|
| Rate for Payer: United Healthcare HMO Rider |
$0.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.18
|
|
|
CEFEPIME (MAXIPIME) 1G/10ML FROZEN SYRINGE [4081917]
|
Facility
|
OP
|
$0.54
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$19.04 |
| Rate for Payer: Cigna of CA PPO |
$0.31
|
| Rate for Payer: Cigna of CA PPO |
$0.38
|
| Rate for Payer: Adventist Health Commercial |
$0.11
|
| Rate for Payer: Adventist Health Commercial |
$0.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cigna of CA HMO |
$0.38
|
| Rate for Payer: Cigna of CA HMO |
$0.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.18
|
| Rate for Payer: EPIC Health Plan Senior |
$0.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.18
|
| Rate for Payer: Galaxy Health WC |
$0.46
|
| Rate for Payer: Galaxy Health WC |
$0.37
|
| Rate for Payer: Global Benefits Group Commercial |
$0.32
|
| Rate for Payer: Global Benefits Group Commercial |
$0.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.31
|
| Rate for Payer: Multiplan Commercial |
$0.43
|
| Rate for Payer: Multiplan Commercial |
$0.35
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Networks By Design Commercial |
$0.22
|
| Rate for Payer: Prime Health Services Commercial |
$0.37
|
| Rate for Payer: Prime Health Services Commercial |
$0.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO |
$0.16
|
| Rate for Payer: United Healthcare All Other HMO |
$0.20
|
| Rate for Payer: United Healthcare HMO Rider |
$0.19
|
| Rate for Payer: United Healthcare HMO Rider |
$0.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.46
|
| Rate for Payer: Vantage Medical Group Senior |
$0.37
|
| Rate for Payer: Vantage Medical Group Senior |
$0.46
|
|
|
CEFEPIME (MAXIPIME) 2G/20ML FROZEN SYRINGE [4081790]
|
Facility
|
OP
|
$0.54
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$19.04 |
| Rate for Payer: Adventist Health Commercial |
$0.11
|
| Rate for Payer: Adventist Health Commercial |
$0.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.04
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3.06
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cigna of CA HMO |
$0.38
|
| Rate for Payer: Cigna of CA HMO |
$0.31
|
| Rate for Payer: Cigna of CA PPO |
$0.31
|
| Rate for Payer: Cigna of CA PPO |
$0.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.37
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.18
|
| Rate for Payer: EPIC Health Plan Senior |
$0.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.18
|
| Rate for Payer: Galaxy Health WC |
$0.46
|
| Rate for Payer: Galaxy Health WC |
$0.37
|
| Rate for Payer: Global Benefits Group Commercial |
$0.32
|
| Rate for Payer: Global Benefits Group Commercial |
$0.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.31
|
| Rate for Payer: Multiplan Commercial |
$0.43
|
| Rate for Payer: Multiplan Commercial |
$0.35
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Networks By Design Commercial |
$0.22
|
| Rate for Payer: Prime Health Services Commercial |
$0.37
|
| Rate for Payer: Prime Health Services Commercial |
$0.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.26
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.32
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO |
$0.16
|
| Rate for Payer: United Healthcare All Other HMO |
$0.20
|
| Rate for Payer: United Healthcare HMO Rider |
$0.19
|
| Rate for Payer: United Healthcare HMO Rider |
$0.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.46
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.46
|
| Rate for Payer: Vantage Medical Group Senior |
$0.37
|
| Rate for Payer: Vantage Medical Group Senior |
$0.46
|
|
|
CEFEPIME (MAXIPIME) 2G/20ML FROZEN SYRINGE [4081790]
|
Facility
|
IP
|
$0.54
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.46 |
| Rate for Payer: Adventist Health Commercial |
$0.11
|
| Rate for Payer: Adventist Health Commercial |
$0.09
|
| Rate for Payer: Blue Shield of California Commercial |
$0.34
|
| Rate for Payer: Blue Shield of California Commercial |
$0.27
|
| Rate for Payer: Blue Shield of California Commercial |
$0.42
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: Cigna of CA HMO |
$0.38
|
| Rate for Payer: Cigna of CA HMO |
$0.31
|
| Rate for Payer: Cigna of CA PPO |
$0.31
|
| Rate for Payer: Cigna of CA PPO |
$0.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.31
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.18
|
| Rate for Payer: EPIC Health Plan Senior |
$0.22
|
| Rate for Payer: Galaxy Health WC |
$0.37
|
| Rate for Payer: Galaxy Health WC |
$0.46
|
| Rate for Payer: Global Benefits Group Commercial |
$0.32
|
| Rate for Payer: Global Benefits Group Commercial |
$0.26
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
| Rate for Payer: Multiplan Commercial |
$0.35
|
| Rate for Payer: Multiplan Commercial |
$0.43
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Networks By Design Commercial |
$0.22
|
| Rate for Payer: Prime Health Services Commercial |
$0.46
|
| Rate for Payer: Prime Health Services Commercial |
$0.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO |
$0.16
|
| Rate for Payer: United Healthcare HMO Rider |
$0.16
|
| Rate for Payer: United Healthcare HMO Rider |
$0.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.18
|
|
|
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION [227170]
|
Facility
|
OP
|
$296.17
|
|
|
Service Code
|
HCPCS J0699
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$251.74 |
| Rate for Payer: Upland Medical Group Pediatric |
$2.55
|
| Rate for Payer: Adventist Health Commercial |
$59.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2.64
|
| Rate for Payer: Cash Price |
$133.28
|
| Rate for Payer: Cash Price |
$133.28
|
| Rate for Payer: Cigna of CA HMO |
$207.32
|
| Rate for Payer: Cigna of CA PPO |
$207.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.21
|
| Rate for Payer: EPIC Health Plan Senior |
$2.81
|
| Rate for Payer: Galaxy Health WC |
$251.74
|
| Rate for Payer: Global Benefits Group Commercial |
$177.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$188.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.42
|
| Rate for Payer: Multiplan Commercial |
$236.94
|
| Rate for Payer: Networks By Design Commercial |
$148.09
|
| Rate for Payer: Prime Health Services Commercial |
$251.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$177.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$177.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$111.15
|
| Rate for Payer: United Healthcare All Other HMO |
$108.19
|
| Rate for Payer: United Healthcare HMO Rider |
$105.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$97.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.81
|
| Rate for Payer: Vantage Medical Group Senior |
$2.81
|
|
|
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION [227170]
|
Facility
|
IP
|
$296.17
|
|
|
Service Code
|
HCPCS J0699
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$59.23 |
| Max. Negotiated Rate |
$251.74 |
| Rate for Payer: Adventist Health Commercial |
$59.23
|
| Rate for Payer: Blue Shield of California Commercial |
$150.16
|
| Rate for Payer: Blue Shield of California Commercial |
$227.75
|
| Rate for Payer: Cash Price |
$133.28
|
| Rate for Payer: Cigna of CA HMO |
$207.32
|
| Rate for Payer: Cigna of CA PPO |
$207.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.47
|
| Rate for Payer: EPIC Health Plan Senior |
$118.47
|
| Rate for Payer: Galaxy Health WC |
$251.74
|
| Rate for Payer: Global Benefits Group Commercial |
$177.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$188.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$174.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.08
|
| Rate for Payer: Multiplan Commercial |
$236.94
|
| Rate for Payer: Networks By Design Commercial |
$148.09
|
| Rate for Payer: Prime Health Services Commercial |
$251.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$111.15
|
| Rate for Payer: United Healthcare All Other HMO |
$108.19
|
| Rate for Payer: United Healthcare HMO Rider |
$105.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$97.00
|
|
|
CEFIDEROCOL (FETROJA) 1 GM/100 ML IVPB [40820782]
|
Facility
|
IP
|
$296.17
|
|
|
Service Code
|
HCPCS J0699
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$59.23 |
| Max. Negotiated Rate |
$251.74 |
| Rate for Payer: Adventist Health Commercial |
$59.23
|
| Rate for Payer: Blue Shield of California Commercial |
$150.16
|
| Rate for Payer: Blue Shield of California Commercial |
$227.75
|
| Rate for Payer: Cash Price |
$133.28
|
| Rate for Payer: Cigna of CA HMO |
$207.32
|
| Rate for Payer: Cigna of CA PPO |
$207.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$118.47
|
| Rate for Payer: EPIC Health Plan Senior |
$118.47
|
| Rate for Payer: Galaxy Health WC |
$251.74
|
| Rate for Payer: Global Benefits Group Commercial |
$177.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$188.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$174.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.08
|
| Rate for Payer: Multiplan Commercial |
$236.94
|
| Rate for Payer: Networks By Design Commercial |
$148.09
|
| Rate for Payer: Prime Health Services Commercial |
$251.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$111.15
|
| Rate for Payer: United Healthcare All Other HMO |
$108.19
|
| Rate for Payer: United Healthcare HMO Rider |
$105.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$97.00
|
|
|
CEFIDEROCOL (FETROJA) 1 GM/100 ML IVPB [40820782]
|
Facility
|
OP
|
$296.17
|
|
|
Service Code
|
HCPCS J0699
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.55 |
| Max. Negotiated Rate |
$251.74 |
| Rate for Payer: Adventist Health Commercial |
$59.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$14.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.81
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.80
|
| Rate for Payer: Blue Shield of California Commercial |
$2.64
|
| Rate for Payer: Cash Price |
$133.28
|
| Rate for Payer: Cash Price |
$133.28
|
| Rate for Payer: Cigna of CA HMO |
$207.32
|
| Rate for Payer: Cigna of CA PPO |
$207.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.19
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$207.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.21
|
| Rate for Payer: EPIC Health Plan Senior |
$2.81
|
| Rate for Payer: Galaxy Health WC |
$251.74
|
| Rate for Payer: Global Benefits Group Commercial |
$177.70
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$4.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.55
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$188.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$71.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.42
|
| Rate for Payer: Multiplan Commercial |
$236.94
|
| Rate for Payer: Networks By Design Commercial |
$148.09
|
| Rate for Payer: Prime Health Services Commercial |
$251.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$177.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$177.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$111.15
|
| Rate for Payer: United Healthcare All Other HMO |
$108.19
|
| Rate for Payer: United Healthcare HMO Rider |
$105.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$97.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.19
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.81
|
| Rate for Payer: Vantage Medical Group Senior |
$2.81
|
|
|
CEFIXIME 200 MG/5 ML ORAL SUSPENSION [81816]
|
Facility
|
OP
|
$8.02
|
|
|
Service Code
|
NDC 6586275275
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$6.82 |
| Rate for Payer: Adventist Health Commercial |
$1.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.15
|
| Rate for Payer: Cash Price |
$3.61
|
| Rate for Payer: Cigna of CA HMO |
$5.61
|
| Rate for Payer: Cigna of CA PPO |
$5.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.82
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.21
|
| Rate for Payer: EPIC Health Plan Senior |
$3.21
|
| Rate for Payer: Galaxy Health WC |
$6.82
|
| Rate for Payer: Global Benefits Group Commercial |
$4.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.92
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.61
|
| Rate for Payer: Multiplan Commercial |
$6.42
|
| Rate for Payer: Networks By Design Commercial |
$5.21
|
| Rate for Payer: Prime Health Services Commercial |
$6.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.01
|
| Rate for Payer: United Healthcare All Other HMO |
$4.01
|
| Rate for Payer: United Healthcare HMO Rider |
$4.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.82
|
| Rate for Payer: Vantage Medical Group Senior |
$6.82
|
|
|
CEFIXIME 200 MG/5 ML ORAL SUSPENSION [81816]
|
Facility
|
IP
|
$8.02
|
|
|
Service Code
|
NDC 6586275275
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$6.82 |
| Rate for Payer: Adventist Health Commercial |
$1.60
|
| Rate for Payer: Blue Shield of California Commercial |
$4.07
|
| Rate for Payer: Blue Shield of California Commercial |
$6.17
|
| Rate for Payer: Cash Price |
$3.61
|
| Rate for Payer: Cigna of CA HMO |
$5.61
|
| Rate for Payer: Cigna of CA PPO |
$5.61
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.21
|
| Rate for Payer: EPIC Health Plan Senior |
$3.21
|
| Rate for Payer: Galaxy Health WC |
$6.82
|
| Rate for Payer: Global Benefits Group Commercial |
$4.81
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.92
|
| Rate for Payer: Multiplan Commercial |
$6.42
|
| Rate for Payer: Networks By Design Commercial |
$5.21
|
| Rate for Payer: Prime Health Services Commercial |
$6.82
|
|
|
CEFOXITIN 10 GRAM INTRAVENOUS SOLUTION (100 MG/ML IVPB) [9462]
|
Facility
|
IP
|
$107.99
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$91.79 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Blue Shield of California Commercial |
$54.75
|
| Rate for Payer: Blue Shield of California Commercial |
$83.04
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cigna of CA HMO |
$75.59
|
| Rate for Payer: Cigna of CA PPO |
$75.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$75.59
|
| 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: Kaiser Foundation Hospitals Commercial/Self Funded |
$68.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$63.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.92
|
| 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: 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
|
|
|
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 |
$4.29 |
| Max. Negotiated Rate |
$91.79 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.51
|
| 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 |
$41.23
|
| Rate for Payer: Blue Shield of California Commercial |
$8.39
|
| Rate for Payer: Cash Price |
$48.60
|
| Rate for Payer: Cash Price |
$48.60
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$75.59
|
| 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 |
$4.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$68.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$63.71
|
| 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
|
$7.20
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$41.23 |
| Rate for Payer: Galaxy Health WC |
$7.13
|
| Rate for Payer: Galaxy Health WC |
$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: Adventist Health Commercial |
$1.44
|
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Adventist Health Commercial |
$1.68
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.10
|
| 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 Medi-Cal |
$4.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.23
|
| 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: Cash Price |
$3.78
|
| Rate for Payer: Cash Price |
$3.24
|
| Rate for Payer: Cash Price |
$5.35
|
| Rate for Payer: Cash Price |
$3.24
|
| Rate for Payer: Cash Price |
$3.78
|
| Rate for Payer: Cash Price |
$5.35
|
| Rate for Payer: Cigna of CA HMO |
$5.87
|
| Rate for Payer: Cigna of CA HMO |
$5.04
|
| Rate for Payer: Cigna of CA HMO |
$8.32
|
| Rate for Payer: Cigna of CA PPO |
$8.32
|
| Rate for Payer: Cigna of CA PPO |
$5.87
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.32
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.04
|
| 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 |
$4.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.33
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.25
|
| 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
|
|
