|
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
|
|
|
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: Cigna of CA PPO |
$6.72
|
| Rate for Payer: Cigna of CA PPO |
$11.72
|
| 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 |
$8.49
|
| Rate for Payer: Blue Shield of California Commercial |
$6.08
|
| Rate for Payer: Blue Shield of California Commercial |
$9.23
|
| Rate for Payer: Blue Shield of California Commercial |
$7.38
|
| Rate for Payer: Blue Shield of California Commercial |
$4.87
|
| Rate for Payer: Blue Shield of California Commercial |
$12.88
|
| Rate for Payer: Cash Price |
$4.32
|
| Rate for Payer: Cash Price |
$7.54
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna of CA HMO |
$6.72
|
| Rate for Payer: Cigna of CA HMO |
$11.72
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6.70
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3.84
|
| Rate for Payer: Galaxy Health WC |
$8.16
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$14.24
|
| 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: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.66
|
| 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
|
$16.75
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$41.23 |
| 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
|
| Rate for Payer: Adventist Health Commercial |
$3.35
|
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Adventist Health Commercial |
$1.92
|
| 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 |
$14.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| 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 Medi-Cal |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.20
|
| 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 |
$4.32
|
| Rate for Payer: Cash Price |
$7.54
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$7.54
|
| Rate for Payer: Cash Price |
$4.32
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cigna of CA HMO |
$6.72
|
| Rate for Payer: Cigna of CA HMO |
$11.72
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$6.72
|
| Rate for Payer: Cigna of CA PPO |
$11.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.72
|
| 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 |
$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 |
$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 |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$6.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.64
|
| 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 |
$7.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.88
|
| 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
|
|
|
CEFPODOXIME 200 MG TABLET [9469]
|
Facility
|
IP
|
$4.48
|
|
|
Service Code
|
NDC 6586209620
|
| 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 |
$2.27
|
| Rate for Payer: Blue Shield of California Commercial |
$3.45
|
| Rate for Payer: Cash Price |
$2.02
|
| Rate for Payer: Cigna of CA HMO |
$3.14
|
| Rate for Payer: Cigna of CA PPO |
$3.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$2.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.64
|
| 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 6586209620
|
| 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 |
$2.87
|
| Rate for Payer: Cash Price |
$2.02
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$2.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.64
|
| 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
|
OP
|
$324.40
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.15 |
| Max. Negotiated Rate |
$275.74 |
| Rate for Payer: Adventist Health Commercial |
$64.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.15
|
| Rate for Payer: Blue Shield of California Commercial |
$6.13
|
| Rate for Payer: Cash Price |
$145.98
|
| Rate for Payer: Cash Price |
$145.98
|
| Rate for Payer: Cigna of CA HMO |
$227.08
|
| Rate for Payer: Cigna of CA PPO |
$227.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.24
|
| Rate for Payer: EPIC Health Plan Senior |
$4.83
|
| Rate for Payer: Galaxy Health WC |
$275.74
|
| Rate for Payer: Global Benefits Group Commercial |
$194.64
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.88
|
| Rate for Payer: Multiplan Commercial |
$259.52
|
| Rate for Payer: Networks By Design Commercial |
$162.20
|
| Rate for Payer: Prime Health Services Commercial |
$275.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$194.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$194.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.75
|
| Rate for Payer: United Healthcare All Other HMO |
$118.50
|
| Rate for Payer: United Healthcare HMO Rider |
$115.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.24
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4.83
|
|
|
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION [107670]
|
Facility
|
IP
|
$324.40
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.88 |
| Max. Negotiated Rate |
$275.74 |
| Rate for Payer: Adventist Health Commercial |
$64.88
|
| Rate for Payer: Blue Shield of California Commercial |
$164.47
|
| Rate for Payer: Blue Shield of California Commercial |
$249.46
|
| Rate for Payer: Cash Price |
$145.98
|
| Rate for Payer: Cigna of CA HMO |
$227.08
|
| Rate for Payer: Cigna of CA PPO |
$227.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.76
|
| Rate for Payer: EPIC Health Plan Senior |
$129.76
|
| Rate for Payer: Galaxy Health WC |
$275.74
|
| Rate for Payer: Global Benefits Group Commercial |
$194.64
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.86
|
| Rate for Payer: Multiplan Commercial |
$259.52
|
| Rate for Payer: Networks By Design Commercial |
$162.20
|
| Rate for Payer: Prime Health Services Commercial |
$275.74
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.75
|
| Rate for Payer: United Healthcare All Other HMO |
$118.50
|
| Rate for Payer: United Healthcare HMO Rider |
$115.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.24
|
|
|
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION [107671]
|
Facility
|
OP
|
$324.40
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.15 |
| Max. Negotiated Rate |
$275.74 |
| Rate for Payer: Adventist Health Commercial |
$64.88
|
| Rate for Payer: Adventist Health Commercial |
$56.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.15
|
| Rate for Payer: Blue Shield of California Commercial |
$6.13
|
| Rate for Payer: Blue Shield of California Commercial |
$6.13
|
| Rate for Payer: Cash Price |
$126.13
|
| Rate for Payer: Cash Price |
$145.98
|
| Rate for Payer: Cash Price |
$126.13
|
| Rate for Payer: Cash Price |
$145.98
|
| Rate for Payer: Cigna of CA HMO |
$227.08
|
| Rate for Payer: Cigna of CA HMO |
$196.20
|
| Rate for Payer: Cigna of CA PPO |
$227.08
|
| Rate for Payer: Cigna of CA PPO |
$196.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$196.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.24
|
| Rate for Payer: EPIC Health Plan Senior |
$4.83
|
| Rate for Payer: EPIC Health Plan Senior |
$4.83
|
| Rate for Payer: Galaxy Health WC |
$238.24
|
| Rate for Payer: Galaxy Health WC |
$275.74
|
| Rate for Payer: Global Benefits Group Commercial |
$168.17
|
| Rate for Payer: Global Benefits Group Commercial |
$194.64
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.20
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$7.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$177.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.53
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.88
|
| Rate for Payer: Multiplan Commercial |
$224.22
|
| Rate for Payer: Multiplan Commercial |
$259.52
|
| Rate for Payer: Networks By Design Commercial |
$162.20
|
| Rate for Payer: Networks By Design Commercial |
$140.14
|
| Rate for Payer: Prime Health Services Commercial |
$238.24
|
| Rate for Payer: Prime Health Services Commercial |
$275.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$194.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$168.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$168.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$194.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$105.19
|
| Rate for Payer: United Healthcare All Other HMO |
$102.39
|
| Rate for Payer: United Healthcare All Other HMO |
$118.50
|
| Rate for Payer: United Healthcare HMO Rider |
$100.17
|
| Rate for Payer: United Healthcare HMO Rider |
$115.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.79
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.39
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4.83
|
|
|
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION [107671]
|
Facility
|
IP
|
$324.40
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$64.88 |
| Max. Negotiated Rate |
$275.74 |
| Rate for Payer: EPIC Health Plan Senior |
$129.76
|
| Rate for Payer: Galaxy Health WC |
$238.24
|
| Rate for Payer: Galaxy Health WC |
$275.74
|
| Rate for Payer: Adventist Health Commercial |
$64.88
|
| Rate for Payer: Adventist Health Commercial |
$56.06
|
| Rate for Payer: Blue Shield of California Commercial |
$215.54
|
| Rate for Payer: Blue Shield of California Commercial |
$164.47
|
| Rate for Payer: Blue Shield of California Commercial |
$249.46
|
| Rate for Payer: Blue Shield of California Commercial |
$142.10
|
| Rate for Payer: Cash Price |
$126.13
|
| Rate for Payer: Cash Price |
$145.98
|
| Rate for Payer: Cigna of CA HMO |
$227.08
|
| Rate for Payer: Cigna of CA HMO |
$196.20
|
| Rate for Payer: Cigna of CA PPO |
$196.20
|
| Rate for Payer: Cigna of CA PPO |
$227.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$196.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$227.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$112.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$129.76
|
| Rate for Payer: EPIC Health Plan Senior |
$112.11
|
| Rate for Payer: Global Benefits Group Commercial |
$194.64
|
| Rate for Payer: Global Benefits Group Commercial |
$168.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$177.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$205.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$165.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$191.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$67.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$77.86
|
| Rate for Payer: Multiplan Commercial |
$224.22
|
| Rate for Payer: Multiplan Commercial |
$259.52
|
| Rate for Payer: Networks By Design Commercial |
$162.20
|
| Rate for Payer: Networks By Design Commercial |
$140.14
|
| Rate for Payer: Prime Health Services Commercial |
$275.74
|
| Rate for Payer: Prime Health Services Commercial |
$238.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$105.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$121.75
|
| Rate for Payer: United Healthcare All Other HMO |
$118.50
|
| Rate for Payer: United Healthcare All Other HMO |
$102.39
|
| Rate for Payer: United Healthcare HMO Rider |
$100.17
|
| Rate for Payer: United Healthcare HMO Rider |
$115.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$106.24
|
|
|
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 |
$2.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3.94
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cigna of CA HMO |
$3.58
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$3.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.02
|
| 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 |
$16.89 |
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| 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 |
$16.89
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cash Price |
$2.30
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.02
|
| 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 |
$16.89 |
| Rate for Payer: Adventist Health Commercial |
$1.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| 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 |
$16.89
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Cash Price |
$3.21
|
| Rate for Payer: Cash Price |
$3.21
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.21
|
| 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 |
$3.62
|
| Rate for Payer: Blue Shield of California Commercial |
$5.49
|
| Rate for Payer: Cash Price |
$3.21
|
| Rate for Payer: Cigna of CA HMO |
$5.00
|
| Rate for Payer: Cigna of CA PPO |
$5.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$4.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.21
|
| 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
|
$6.24
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.25 |
| Max. Negotiated Rate |
$5.30 |
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Adventist Health Commercial |
$0.78
|
| Rate for Payer: Adventist Health Commercial |
$1.08
|
| Rate for Payer: Adventist Health Commercial |
$1.43
|
| Rate for Payer: Blue Shield of California Commercial |
$3.94
|
| Rate for Payer: Blue Shield of California Commercial |
$2.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2.74
|
| Rate for Payer: Blue Shield of California Commercial |
$3.62
|
| Rate for Payer: Blue Shield of California Commercial |
$5.49
|
| Rate for Payer: Blue Shield of California Commercial |
$4.15
|
| Rate for Payer: Blue Shield of California Commercial |
$4.80
|
| Rate for Payer: Blue Shield of California Commercial |
$1.98
|
| Rate for Payer: Blue Shield of California Commercial |
$3.16
|
| Rate for Payer: Cash Price |
$3.21
|
| Rate for Payer: Cash Price |
$2.43
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cash Price |
$1.76
|
| Rate for Payer: Cash Price |
$2.81
|
| 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 |
$2.74
|
| Rate for Payer: Cigna of CA HMO |
$3.58
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.50
|
| 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 Senior |
$1.56
|
| Rate for Payer: EPIC Health Plan Senior |
$2.50
|
| Rate for Payer: EPIC Health Plan Senior |
$2.86
|
| Rate for Payer: EPIC Health Plan Senior |
$2.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| Rate for Payer: Galaxy Health WC |
$4.35
|
| Rate for Payer: Galaxy Health WC |
$4.59
|
| Rate for Payer: Galaxy Health WC |
$6.07
|
| Rate for Payer: Galaxy Health WC |
$5.30
|
| Rate for Payer: Galaxy Health WC |
$3.32
|
| 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 |
$4.28
|
| Rate for Payer: Global Benefits Group Commercial |
$3.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.21
|
| 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
|
|
|
CEFTAZIDIME 1 GRAM SOLUTION FOR INJECTION (200 MG/ML RECONST) [4081895]
|
Facility
|
OP
|
$5.12
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$16.89 |
| Rate for Payer: Dignity Health Medi-Cal |
$6.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.35
|
| 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: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Adventist Health Commercial |
$0.78
|
| Rate for Payer: Adventist Health Commercial |
$1.08
|
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Adventist Health Commercial |
$1.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| 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 Commercial/Exchange |
$3.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.93
|
| 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 |
$3.84
|
| 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: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| 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: Cash Price |
$3.21
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$2.43
|
| Rate for Payer: Cash Price |
$2.43
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$3.21
|
| Rate for Payer: Cash Price |
$1.76
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cash Price |
$1.76
|
| 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 HMO |
$2.74
|
| Rate for Payer: Cigna of CA HMO |
$5.00
|
| Rate for Payer: Cigna of CA PPO |
$3.78
|
| Rate for Payer: Cigna of CA PPO |
$4.37
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: Cigna of CA PPO |
$5.00
|
| Rate for Payer: Cigna of CA PPO |
$2.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.07
|
| 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 |
$5.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$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 |
$6.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.58
|
| 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 |
$1.56
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| 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 |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.59
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.31
|
| 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 |
$16.89 |
| Rate for Payer: Cash Price |
$1.76
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$2.43
|
| 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 |
$2.74
|
| Rate for Payer: Cigna of CA HMO |
$4.37
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: Cigna of CA PPO |
$4.37
|
| Rate for Payer: Cigna of CA PPO |
$2.74
|
| Rate for Payer: Cigna of CA PPO |
$3.78
|
| Rate for Payer: Adventist Health Commercial |
$1.08
|
| Rate for Payer: Adventist Health Commercial |
$0.78
|
| Rate for Payer: Adventist Health Commercial |
$1.25
|
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.35
|
| 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 Medi-Cal |
$3.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.93
|
| 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: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| 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: Cash Price |
$2.43
|
| Rate for Payer: Cash Price |
$1.76
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.32
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.37
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| Rate for Payer: EPIC Health Plan Senior |
$2.50
|
| Rate for Payer: EPIC Health Plan Senior |
$2.16
|
| Rate for Payer: EPIC Health Plan Senior |
$1.56
|
| Rate for Payer: Galaxy Health WC |
$5.30
|
| 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 |
$3.24
|
| 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 |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.48
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.68
|
| 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
|
|
|
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: EPIC Health Plan Commercial |
$1.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.05
|
| 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 |
$2.05
|
| Rate for Payer: EPIC Health Plan Senior |
$2.16
|
| Rate for Payer: EPIC Health Plan Senior |
$2.50
|
| Rate for Payer: Galaxy Health WC |
$5.30
|
| Rate for Payer: Galaxy Health WC |
$3.32
|
| Rate for Payer: Galaxy Health WC |
$4.59
|
| Rate for Payer: Galaxy Health WC |
$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 |
$4.15
|
| Rate for Payer: Blue Shield of California Commercial |
$1.98
|
| Rate for Payer: Blue Shield of California Commercial |
$3.16
|
| Rate for Payer: Blue Shield of California Commercial |
$3.94
|
| Rate for Payer: Blue Shield of California Commercial |
$2.60
|
| Rate for Payer: Blue Shield of California Commercial |
$3.01
|
| Rate for Payer: Blue Shield of California Commercial |
$2.74
|
| Rate for Payer: Blue Shield of California Commercial |
$4.80
|
| Rate for Payer: Cash Price |
$2.30
|
| Rate for Payer: Cash Price |
$1.76
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$2.43
|
| 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 |
$2.74
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.37
|
| 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 |
$3.74
|
| Rate for Payer: Global Benefits Group Commercial |
$2.35
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.96
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.68
|
| 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
|
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 |
$11.16
|
| Rate for Payer: Blue Shield of California Commercial |
$7.36
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cigna of CA HMO |
$10.16
|
| Rate for Payer: Cigna of CA PPO |
$10.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$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 Foundation Hospitals Commercial/Self Funded |
$9.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.56
|
| 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 INTRAVENOUS SOLUTION [111787]
|
Facility
|
OP
|
$14.51
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$16.89 |
| Rate for Payer: Adventist Health Commercial |
$2.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| 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 |
$16.89
|
| Rate for Payer: Blue Shield of California Commercial |
$2.56
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cash Price |
$6.53
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$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: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.56
|
| 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 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 |
$9.23
|
| Rate for Payer: Blue Shield of California Commercial |
$5.81
|
| Rate for Payer: Blue Shield of California Commercial |
$8.81
|
| Rate for Payer: Blue Shield of California Commercial |
$6.69
|
| Rate for Payer: Blue Shield of California Commercial |
$10.15
|
| Rate for Payer: Blue Shield of California Commercial |
$6.08
|
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.16
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.58
|
| 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 |
$11.22
|
| Rate for Payer: Galaxy Health WC |
$9.74
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| 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: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.79
|
| 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 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 |
$1.44 |
| Max. Negotiated Rate |
$16.89 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Adventist Health Commercial |
$2.29
|
| Rate for Payer: Adventist Health Commercial |
$2.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Networks By Design Commercial |
$5.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.30
|
| 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 |
$8.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| 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: Cash Price |
$5.16
|
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Cash Price |
$5.16
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA HMO |
$9.24
|
| Rate for Payer: Cigna of CA HMO |
$8.02
|
| Rate for Payer: Cigna of CA PPO |
$9.24
|
| Rate for Payer: Cigna of CA PPO |
$8.02
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.22
|
| 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 |
$11.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.24
|
| 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 |
$4.58
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| 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 |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.38
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$4.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.79
|
| 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: 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 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: 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 |
$26.91
|
| Rate for Payer: Blue Shield of California Commercial |
$13.20
|
| Rate for Payer: Blue Shield of California Commercial |
$18.60
|
| Rate for Payer: Blue Shield of California Commercial |
$22.15
|
| Rate for Payer: Blue Shield of California Commercial |
$14.60
|
| Rate for Payer: Blue Shield of California Commercial |
$20.02
|
| Rate for Payer: Blue Shield of California Commercial |
$17.75
|
| Rate for Payer: Blue Shield of California Commercial |
$28.21
|
| Rate for Payer: Cash Price |
$12.96
|
| Rate for Payer: Cash Price |
$11.71
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$15.75
|
| 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 |
$18.22
|
| 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: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.67
|
| 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 |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14.67
|
| Rate for Payer: Galaxy Health WC |
$31.18
|
| Rate for Payer: Galaxy Health WC |
$22.13
|
| Rate for Payer: Galaxy Health WC |
$29.75
|
| Rate for Payer: Galaxy Health WC |
$24.48
|
| 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 |
$22.01
|
| Rate for Payer: Global Benefits Group Commercial |
$15.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.64
|
| 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
|
|
|
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 |
$1.44 |
| Max. Negotiated Rate |
$29.75 |
| 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: Adventist Health Commercial |
$7.00
|
| Rate for Payer: Adventist Health Commercial |
$5.21
|
| Rate for Payer: Adventist Health Commercial |
$7.34
|
| Rate for Payer: Adventist Health Commercial |
$5.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$31.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$24.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$22.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$29.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$20.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$19.52
|
| 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: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.89
|
| 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: Cash Price |
$15.75
|
| Rate for Payer: Cash Price |
$11.71
|
| Rate for Payer: Cash Price |
$12.96
|
| Rate for Payer: Cash Price |
$12.96
|
| Rate for Payer: Cash Price |
$11.71
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$16.51
|
| Rate for Payer: Cash Price |
$15.75
|
| 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 |
$18.22
|
| Rate for Payer: Cigna of CA HMO |
$25.68
|
| Rate for Payer: Cigna of CA PPO |
$20.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$29.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$31.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$29.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$31.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$31.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$24.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$22.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$29.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$25.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$24.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$20.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$11.52
|
| Rate for Payer: EPIC Health Plan Senior |
$14.67
|
| Rate for Payer: EPIC Health Plan Senior |
$14.00
|
| Rate for Payer: EPIC Health Plan Senior |
$10.41
|
| Rate for Payer: Galaxy Health WC |
$31.18
|
| 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: 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 |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$1.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$23.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$18.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$22.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.64
|
| 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
|
|
|
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION [205130]
|
Facility
|
IP
|
$523.36
|
|
|
Service Code
|
HCPCS J0714
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$104.67 |
| Max. Negotiated Rate |
$444.86 |
| Rate for Payer: Adventist Health Commercial |
$104.67
|
| Rate for Payer: Blue Shield of California Commercial |
$265.34
|
| Rate for Payer: Blue Shield of California Commercial |
$402.46
|
| Rate for Payer: Cash Price |
$235.51
|
| Rate for Payer: Cigna of CA HMO |
$366.35
|
| Rate for Payer: Cigna of CA PPO |
$366.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$366.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$209.34
|
| Rate for Payer: EPIC Health Plan Senior |
$209.34
|
| Rate for Payer: Galaxy Health WC |
$444.86
|
| Rate for Payer: Global Benefits Group Commercial |
$314.02
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$332.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$308.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.61
|
| Rate for Payer: Multiplan Commercial |
$418.69
|
| Rate for Payer: Networks By Design Commercial |
$261.68
|
| Rate for Payer: Prime Health Services Commercial |
$444.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$196.42
|
| Rate for Payer: United Healthcare All Other HMO |
$191.18
|
| Rate for Payer: United Healthcare HMO Rider |
$187.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$171.40
|
|
|
CEFTAZIDIME-AVIBACTAM 2.5 GRAM INTRAVENOUS SOLUTION [205130]
|
Facility
|
OP
|
$523.36
|
|
|
Service Code
|
HCPCS J0714
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$104.67 |
| Max. Negotiated Rate |
$632.06 |
| Rate for Payer: Adventist Health Commercial |
$104.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$632.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$137.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$120.75
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$120.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$181.99
|
| Rate for Payer: Blue Shield of California Commercial |
$118.68
|
| Rate for Payer: Cash Price |
$235.51
|
| Rate for Payer: Cash Price |
$235.51
|
| Rate for Payer: Cigna of CA HMO |
$366.35
|
| Rate for Payer: Cigna of CA PPO |
$366.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$137.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$120.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$120.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$366.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$181.12
|
| Rate for Payer: EPIC Health Plan Senior |
$120.75
|
| Rate for Payer: Galaxy Health WC |
$444.86
|
| Rate for Payer: Global Benefits Group Commercial |
$314.02
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$180.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$109.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$109.77
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$332.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$198.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$153.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$125.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$138.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$147.09
|
| Rate for Payer: Multiplan Commercial |
$418.69
|
| Rate for Payer: Networks By Design Commercial |
$261.68
|
| Rate for Payer: Prime Health Services Commercial |
$444.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$314.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$314.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$196.42
|
| Rate for Payer: United Healthcare All Other HMO |
$191.18
|
| Rate for Payer: United Healthcare HMO Rider |
$187.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$171.40
|
| Rate for Payer: Upland Medical Group Pediatric |
$109.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$137.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$120.75
|
| Rate for Payer: Vantage Medical Group Senior |
$120.75
|
|
