|
METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE [4989]
|
Facility
IP
|
$2.02
|
|
|
Service Code
|
NDC 10702-076-06
|
| Hospital Charge Code |
1734066
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.48 |
| Max. Negotiated Rate |
$1.72 |
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California EPN |
$1.03
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Cigna of CA HMO |
$1.41
|
| Rate for Payer: Cigna of CA PPO |
$1.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.81
|
| Rate for Payer: Galaxy Health WC |
$1.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.48
|
| Rate for Payer: Multiplan Commercial |
$1.62
|
| Rate for Payer: Networks By Design Commercial |
$1.31
|
| Rate for Payer: Prime Health Services Commercial |
$1.72
|
|
|
METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR [32654]
|
Facility
IP
|
$15.87
|
|
|
Service Code
|
NDC 50458-588-01
|
| Hospital Charge Code |
1731019
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$13.49 |
| Rate for Payer: Blue Shield of California Commercial |
$11.30
|
| Rate for Payer: Blue Shield of California EPN |
$8.13
|
| Rate for Payer: Cash Price |
$7.14
|
| Rate for Payer: Cigna of CA HMO |
$11.11
|
| Rate for Payer: Cigna of CA PPO |
$11.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.35
|
| Rate for Payer: Galaxy Health WC |
$13.49
|
| Rate for Payer: Global Benefits Group Commercial |
$9.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.81
|
| Rate for Payer: Multiplan Commercial |
$12.70
|
| Rate for Payer: Networks By Design Commercial |
$10.32
|
| Rate for Payer: Prime Health Services Commercial |
$13.49
|
|
|
METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR [32654]
|
Facility
OP
|
$15.87
|
|
|
Service Code
|
NDC 50458-588-01
|
| Hospital Charge Code |
1731019
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.81 |
| Max. Negotiated Rate |
$13.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$10.41
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.49
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.73
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.46
|
| Rate for Payer: BCBS Transplant Transplant |
$9.52
|
| Rate for Payer: Blue Shield of California Commercial |
$11.70
|
| Rate for Payer: Blue Shield of California EPN |
$9.27
|
| Rate for Payer: Cash Price |
$7.14
|
| Rate for Payer: Cigna of CA HMO |
$11.11
|
| Rate for Payer: Cigna of CA PPO |
$11.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.49
|
| Rate for Payer: Dignity Health Media |
$13.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.35
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.35
|
| Rate for Payer: Galaxy Health WC |
$13.49
|
| Rate for Payer: Global Benefits Group Commercial |
$9.52
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11.90
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.81
|
| Rate for Payer: Multiplan Commercial |
$12.70
|
| Rate for Payer: Networks By Design Commercial |
$10.32
|
| Rate for Payer: Prime Health Services Commercial |
$13.49
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.52
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.94
|
| Rate for Payer: United Healthcare All Other HMO |
$7.94
|
| Rate for Payer: United Healthcare HMO Rider |
$7.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.49
|
| Rate for Payer: Vantage Medical Group Senior |
$13.49
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]
|
Facility
IP
|
$12.42
|
|
|
Service Code
|
NDC 68084-829-95
|
| Hospital Charge Code |
1731018
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Blue Shield of California Commercial |
$8.84
|
| Rate for Payer: Blue Shield of California EPN |
$6.36
|
| Rate for Payer: Cash Price |
$5.59
|
| Rate for Payer: Cigna of CA HMO |
$8.69
|
| Rate for Payer: Cigna of CA PPO |
$8.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.97
|
| Rate for Payer: Galaxy Health WC |
$10.56
|
| Rate for Payer: Global Benefits Group Commercial |
$7.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.98
|
| Rate for Payer: Multiplan Commercial |
$9.94
|
| Rate for Payer: Networks By Design Commercial |
$8.07
|
| Rate for Payer: Prime Health Services Commercial |
$10.56
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]
|
Facility
OP
|
$16.37
|
|
|
Service Code
|
NDC 50458-586-01
|
| Hospital Charge Code |
1731018
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$13.91 |
| Rate for Payer: Galaxy Health WC |
$13.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$13.91
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.00
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.75
|
| Rate for Payer: BCBS Transplant Transplant |
$9.82
|
| Rate for Payer: Blue Shield of California Commercial |
$12.06
|
| Rate for Payer: Blue Shield of California EPN |
$9.56
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO |
$11.46
|
| Rate for Payer: Cigna of CA PPO |
$11.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.91
|
| Rate for Payer: Dignity Health Media |
$13.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.91
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.55
|
| Rate for Payer: Global Benefits Group Commercial |
$9.82
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$12.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$13.10
|
| Rate for Payer: Networks By Design Commercial |
$10.64
|
| Rate for Payer: Prime Health Services Commercial |
$13.91
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.18
|
| Rate for Payer: United Healthcare All Other HMO |
$8.18
|
| Rate for Payer: United Healthcare HMO Rider |
$8.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.91
|
| Rate for Payer: Vantage Medical Group Senior |
$13.91
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]
|
Facility
OP
|
$12.42
|
|
|
Service Code
|
NDC 68084-829-95
|
| Hospital Charge Code |
1731018
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.40
|
| Rate for Payer: BCBS Transplant Transplant |
$7.45
|
| Rate for Payer: Blue Shield of California Commercial |
$9.15
|
| Rate for Payer: Blue Shield of California EPN |
$7.25
|
| Rate for Payer: Cash Price |
$5.59
|
| Rate for Payer: Cigna of CA HMO |
$8.69
|
| Rate for Payer: Cigna of CA PPO |
$8.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.56
|
| Rate for Payer: Dignity Health Media |
$10.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.97
|
| Rate for Payer: Galaxy Health WC |
$10.56
|
| Rate for Payer: Global Benefits Group Commercial |
$7.45
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.98
|
| Rate for Payer: Multiplan Commercial |
$9.94
|
| Rate for Payer: Networks By Design Commercial |
$8.07
|
| Rate for Payer: Prime Health Services Commercial |
$10.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.21
|
| Rate for Payer: United Healthcare All Other HMO |
$6.21
|
| Rate for Payer: United Healthcare HMO Rider |
$6.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.56
|
| Rate for Payer: Vantage Medical Group Senior |
$10.56
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]
|
Facility
IP
|
$12.42
|
|
|
Service Code
|
NDC 68084-829-25
|
| Hospital Charge Code |
1731018
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Blue Shield of California Commercial |
$8.84
|
| Rate for Payer: Blue Shield of California EPN |
$6.36
|
| Rate for Payer: Cash Price |
$5.59
|
| Rate for Payer: Cigna of CA HMO |
$8.69
|
| Rate for Payer: Cigna of CA PPO |
$8.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.97
|
| Rate for Payer: Galaxy Health WC |
$10.56
|
| Rate for Payer: Global Benefits Group Commercial |
$7.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.98
|
| Rate for Payer: Multiplan Commercial |
$9.94
|
| Rate for Payer: Networks By Design Commercial |
$8.07
|
| Rate for Payer: Prime Health Services Commercial |
$10.56
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]
|
Facility
IP
|
$16.37
|
|
|
Service Code
|
NDC 50458-586-01
|
| Hospital Charge Code |
1731018
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.93 |
| Max. Negotiated Rate |
$13.91 |
| Rate for Payer: Blue Shield of California Commercial |
$11.66
|
| Rate for Payer: Blue Shield of California EPN |
$8.38
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Cigna of CA HMO |
$11.46
|
| Rate for Payer: Cigna of CA PPO |
$11.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.55
|
| Rate for Payer: Galaxy Health WC |
$13.91
|
| Rate for Payer: Global Benefits Group Commercial |
$9.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.93
|
| Rate for Payer: Multiplan Commercial |
$13.10
|
| Rate for Payer: Networks By Design Commercial |
$10.64
|
| Rate for Payer: Prime Health Services Commercial |
$13.91
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]
|
Facility
OP
|
$12.42
|
|
|
Service Code
|
NDC 68084-829-25
|
| Hospital Charge Code |
1731018
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.98 |
| Max. Negotiated Rate |
$10.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$8.15
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.40
|
| Rate for Payer: BCBS Transplant Transplant |
$7.45
|
| Rate for Payer: Blue Shield of California Commercial |
$9.15
|
| Rate for Payer: Blue Shield of California EPN |
$7.25
|
| Rate for Payer: Cash Price |
$5.59
|
| Rate for Payer: Cigna of CA HMO |
$8.69
|
| Rate for Payer: Cigna of CA PPO |
$8.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.56
|
| Rate for Payer: Dignity Health Media |
$10.56
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.97
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.97
|
| Rate for Payer: Galaxy Health WC |
$10.56
|
| Rate for Payer: Global Benefits Group Commercial |
$7.45
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$9.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.98
|
| Rate for Payer: Multiplan Commercial |
$9.94
|
| Rate for Payer: Networks By Design Commercial |
$8.07
|
| Rate for Payer: Prime Health Services Commercial |
$10.56
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$7.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.21
|
| Rate for Payer: United Healthcare All Other HMO |
$6.21
|
| Rate for Payer: United Healthcare HMO Rider |
$6.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.56
|
| Rate for Payer: Vantage Medical Group Senior |
$10.56
|
|
|
METHYLPHENIDATE LA 20 MG BIPHASIC 50-50 CAPSULE,EXTENDED RELEASE [33198]
|
Facility
OP
|
$13.78
|
|
|
Service Code
|
NDC 0078-0370-05
|
| Hospital Charge Code |
1730090
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$11.71 |
| Rate for Payer: BCBS Transplant Transplant |
$8.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.04
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.71
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.21
|
| Rate for Payer: Blue Shield of California Commercial |
$10.16
|
| Rate for Payer: Blue Shield of California EPN |
$8.05
|
| Rate for Payer: Cash Price |
$6.20
|
| Rate for Payer: Cigna of CA HMO |
$9.65
|
| Rate for Payer: Cigna of CA PPO |
$9.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.71
|
| Rate for Payer: Dignity Health Media |
$11.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.51
|
| Rate for Payer: Galaxy Health WC |
$11.71
|
| Rate for Payer: Global Benefits Group Commercial |
$8.27
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.31
|
| Rate for Payer: Multiplan Commercial |
$11.02
|
| Rate for Payer: Networks By Design Commercial |
$8.96
|
| Rate for Payer: Prime Health Services Commercial |
$11.71
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$8.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.89
|
| Rate for Payer: United Healthcare All Other HMO |
$6.89
|
| Rate for Payer: United Healthcare HMO Rider |
$6.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.71
|
| Rate for Payer: Vantage Medical Group Senior |
$11.71
|
|
|
METHYLPHENIDATE LA 20 MG BIPHASIC 50-50 CAPSULE,EXTENDED RELEASE [33198]
|
Facility
IP
|
$13.78
|
|
|
Service Code
|
NDC 0078-0370-05
|
| Hospital Charge Code |
1730090
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.31 |
| Max. Negotiated Rate |
$11.71 |
| Rate for Payer: Blue Shield of California Commercial |
$9.81
|
| Rate for Payer: Blue Shield of California EPN |
$7.06
|
| Rate for Payer: Cash Price |
$6.20
|
| Rate for Payer: Cigna of CA HMO |
$9.65
|
| Rate for Payer: Cigna of CA PPO |
$9.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.51
|
| Rate for Payer: Galaxy Health WC |
$11.71
|
| Rate for Payer: Global Benefits Group Commercial |
$8.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.31
|
| Rate for Payer: Multiplan Commercial |
$11.02
|
| Rate for Payer: Networks By Design Commercial |
$8.96
|
| Rate for Payer: Prime Health Services Commercial |
$11.71
|
|
|
METHYLPREDNISOLONE 125 MG INJ. [4081205]
|
Facility
IP
|
$13.98
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
1720347
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$11.88 |
| Rate for Payer: Blue Shield of California Commercial |
$9.95
|
| Rate for Payer: Blue Shield of California Commercial |
$8.32
|
| Rate for Payer: Blue Shield of California Commercial |
$6.49
|
| Rate for Payer: Blue Shield of California EPN |
$4.67
|
| Rate for Payer: Blue Shield of California EPN |
$7.16
|
| Rate for Payer: Blue Shield of California EPN |
$5.98
|
| Rate for Payer: Cash Price |
$5.26
|
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cigna of CA HMO |
$9.79
|
| Rate for Payer: Cigna of CA HMO |
$6.38
|
| Rate for Payer: Cigna of CA HMO |
$8.18
|
| Rate for Payer: Cigna of CA PPO |
$6.38
|
| Rate for Payer: Cigna of CA PPO |
$8.18
|
| Rate for Payer: Cigna of CA PPO |
$9.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.65
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.59
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.65
|
| Rate for Payer: Galaxy Health WC |
$7.75
|
| Rate for Payer: Galaxy Health WC |
$11.88
|
| Rate for Payer: Galaxy Health WC |
$9.93
|
| Rate for Payer: Global Benefits Group Commercial |
$7.01
|
| Rate for Payer: Global Benefits Group Commercial |
$5.47
|
| Rate for Payer: Global Benefits Group Commercial |
$8.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Multiplan Commercial |
$9.34
|
| Rate for Payer: Multiplan Commercial |
$11.18
|
| Rate for Payer: Multiplan Commercial |
$7.30
|
| Rate for Payer: Networks By Design Commercial |
$5.84
|
| Rate for Payer: Networks By Design Commercial |
$6.99
|
| Rate for Payer: Networks By Design Commercial |
$4.56
|
| Rate for Payer: Prime Health Services Commercial |
$11.88
|
| Rate for Payer: Prime Health Services Commercial |
$9.93
|
| Rate for Payer: Prime Health Services Commercial |
$7.75
|
|
|
METHYLPREDNISOLONE 125 MG INJ. [4081205]
|
Facility
OP
|
$13.98
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
1720347
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.36 |
| Max. Negotiated Rate |
$36.99 |
| Rate for Payer: Aetna of CA HMO/PPO |
$36.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.99
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.75
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.42
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.69
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.42
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.50
|
| Rate for Payer: BCBS Transplant Transplant |
$5.47
|
| Rate for Payer: BCBS Transplant Transplant |
$7.01
|
| Rate for Payer: BCBS Transplant Transplant |
$8.39
|
| Rate for Payer: Blue Shield of California Commercial |
$10.30
|
| Rate for Payer: Blue Shield of California Commercial |
$8.61
|
| Rate for Payer: Blue Shield of California Commercial |
$6.72
|
| Rate for Payer: Blue Shield of California EPN |
$8.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.51
|
| Rate for Payer: Cash Price |
$5.26
|
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cash Price |
$5.26
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cigna of CA HMO |
$9.79
|
| Rate for Payer: Cigna of CA HMO |
$6.38
|
| Rate for Payer: Cigna of CA HMO |
$8.18
|
| Rate for Payer: Cigna of CA PPO |
$6.38
|
| Rate for Payer: Cigna of CA PPO |
$8.18
|
| Rate for Payer: Cigna of CA PPO |
$9.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.93
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.88
|
| Rate for Payer: Dignity Health Media |
$9.93
|
| Rate for Payer: Dignity Health Media |
$7.75
|
| Rate for Payer: Dignity Health Media |
$11.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.65
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.65
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.59
|
| Rate for Payer: Galaxy Health WC |
$9.93
|
| Rate for Payer: Galaxy Health WC |
$11.88
|
| Rate for Payer: Galaxy Health WC |
$7.75
|
| Rate for Payer: Global Benefits Group Commercial |
$8.39
|
| Rate for Payer: Global Benefits Group Commercial |
$7.01
|
| Rate for Payer: Global Benefits Group Commercial |
$5.47
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.84
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$8.76
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.36
|
| Rate for Payer: Multiplan Commercial |
$7.30
|
| Rate for Payer: Multiplan Commercial |
$11.18
|
| Rate for Payer: Multiplan Commercial |
$9.34
|
| Rate for Payer: Networks By Design Commercial |
$6.99
|
| Rate for Payer: Networks By Design Commercial |
$5.84
|
| Rate for Payer: Networks By Design Commercial |
$4.56
|
| Rate for Payer: Prime Health Services Commercial |
$11.88
|
| Rate for Payer: Prime Health Services Commercial |
$7.75
|
| Rate for Payer: Prime Health Services Commercial |
$9.93
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.99
|
| Rate for Payer: United Healthcare All Other HMO |
$5.84
|
| Rate for Payer: United Healthcare All Other HMO |
$4.56
|
| Rate for Payer: United Healthcare All Other HMO |
$6.99
|
| Rate for Payer: United Healthcare HMO Rider |
$4.56
|
| Rate for Payer: United Healthcare HMO Rider |
$5.84
|
| Rate for Payer: United Healthcare HMO Rider |
$6.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.93
|
| Rate for Payer: Vantage Medical Group Senior |
$11.88
|
| Rate for Payer: Vantage Medical Group Senior |
$9.93
|
| Rate for Payer: Vantage Medical Group Senior |
$7.75
|
|
|
METHYLPREDNISOLONE 16 MG TABLET [4992]
|
Facility
OP
|
$2.98
|
|
|
Service Code
|
CPT J7509
|
| Hospital Charge Code |
1710277
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$2.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2.53
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.64
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: BCBS Transplant Transplant |
$1.79
|
| Rate for Payer: Blue Shield of California Commercial |
$2.20
|
| Rate for Payer: Blue Shield of California EPN |
$1.17
|
| Rate for Payer: Cash Price |
$1.34
|
| Rate for Payer: Cash Price |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$2.09
|
| Rate for Payer: Cigna of CA PPO |
$2.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.53
|
| Rate for Payer: Dignity Health Media |
$2.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.19
|
| Rate for Payer: Galaxy Health WC |
$2.53
|
| Rate for Payer: Global Benefits Group Commercial |
$1.79
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: Multiplan Commercial |
$2.38
|
| Rate for Payer: Networks By Design Commercial |
$1.49
|
| Rate for Payer: Prime Health Services Commercial |
$2.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.49
|
| Rate for Payer: United Healthcare All Other HMO |
$1.49
|
| Rate for Payer: United Healthcare HMO Rider |
$1.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.53
|
| Rate for Payer: Vantage Medical Group Senior |
$2.53
|
|
|
METHYLPREDNISOLONE 16 MG TABLET [4992]
|
Facility
IP
|
$2.98
|
|
|
Service Code
|
CPT J7509
|
| Hospital Charge Code |
1710277
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.72 |
| Max. Negotiated Rate |
$2.53 |
| Rate for Payer: Blue Shield of California Commercial |
$2.12
|
| Rate for Payer: Blue Shield of California EPN |
$1.53
|
| Rate for Payer: Cash Price |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$2.09
|
| Rate for Payer: Cigna of CA PPO |
$2.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.19
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.19
|
| Rate for Payer: Galaxy Health WC |
$2.53
|
| Rate for Payer: Global Benefits Group Commercial |
$1.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.72
|
| Rate for Payer: Multiplan Commercial |
$2.38
|
| Rate for Payer: Networks By Design Commercial |
$1.49
|
| Rate for Payer: Prime Health Services Commercial |
$2.53
|
|
|
METHYLPREDNISOLONE 32 MG TABLET [10575]
|
Facility
IP
|
$4.96
|
|
|
Service Code
|
CPT J7509
|
| Hospital Charge Code |
1712385
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.19 |
| Max. Negotiated Rate |
$4.22 |
| Rate for Payer: Blue Shield of California Commercial |
$3.53
|
| Rate for Payer: Blue Shield of California Commercial |
$3.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.27
|
| Rate for Payer: Blue Shield of California EPN |
$2.54
|
| Rate for Payer: Cash Price |
$2.00
|
| Rate for Payer: Cash Price |
$2.23
|
| Rate for Payer: Cigna of CA HMO |
$3.47
|
| Rate for Payer: Cigna of CA HMO |
$3.11
|
| Rate for Payer: Cigna of CA PPO |
$3.11
|
| Rate for Payer: Cigna of CA PPO |
$3.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.98
|
| Rate for Payer: Galaxy Health WC |
$4.22
|
| Rate for Payer: Galaxy Health WC |
$3.77
|
| Rate for Payer: Global Benefits Group Commercial |
$2.98
|
| Rate for Payer: Global Benefits Group Commercial |
$2.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.19
|
| Rate for Payer: Multiplan Commercial |
$3.55
|
| Rate for Payer: Multiplan Commercial |
$3.97
|
| Rate for Payer: Networks By Design Commercial |
$2.22
|
| Rate for Payer: Networks By Design Commercial |
$2.48
|
| Rate for Payer: Prime Health Services Commercial |
$3.77
|
| Rate for Payer: Prime Health Services Commercial |
$4.22
|
|
|
METHYLPREDNISOLONE 32 MG TABLET [10575]
|
Facility
OP
|
$4.96
|
|
|
Service Code
|
CPT J7509
|
| Hospital Charge Code |
1712385
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.83 |
| Max. Negotiated Rate |
$4.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.73
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.44
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.73
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: BCBS Transplant Transplant |
$2.98
|
| Rate for Payer: BCBS Transplant Transplant |
$2.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3.66
|
| Rate for Payer: Blue Shield of California Commercial |
$3.27
|
| Rate for Payer: Blue Shield of California EPN |
$1.17
|
| Rate for Payer: Blue Shield of California EPN |
$1.17
|
| Rate for Payer: Cash Price |
$2.23
|
| Rate for Payer: Cash Price |
$2.23
|
| Rate for Payer: Cash Price |
$2.00
|
| Rate for Payer: Cash Price |
$2.00
|
| Rate for Payer: Cigna of CA HMO |
$3.47
|
| Rate for Payer: Cigna of CA HMO |
$3.11
|
| Rate for Payer: Cigna of CA PPO |
$3.47
|
| Rate for Payer: Cigna of CA PPO |
$3.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.22
|
| Rate for Payer: Dignity Health Media |
$4.22
|
| Rate for Payer: Dignity Health Media |
$3.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.98
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.78
|
| Rate for Payer: Galaxy Health WC |
$3.77
|
| Rate for Payer: Galaxy Health WC |
$4.22
|
| Rate for Payer: Global Benefits Group Commercial |
$2.98
|
| Rate for Payer: Global Benefits Group Commercial |
$2.66
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.72
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.33
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.07
|
| Rate for Payer: Multiplan Commercial |
$3.97
|
| Rate for Payer: Multiplan Commercial |
$3.55
|
| Rate for Payer: Networks By Design Commercial |
$2.22
|
| Rate for Payer: Networks By Design Commercial |
$2.48
|
| Rate for Payer: Prime Health Services Commercial |
$3.77
|
| Rate for Payer: Prime Health Services Commercial |
$4.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.22
|
| Rate for Payer: United Healthcare All Other HMO |
$2.48
|
| Rate for Payer: United Healthcare All Other HMO |
$2.22
|
| Rate for Payer: United Healthcare HMO Rider |
$2.22
|
| Rate for Payer: United Healthcare HMO Rider |
$2.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.48
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.22
|
| Rate for Payer: Vantage Medical Group Senior |
$3.77
|
| Rate for Payer: Vantage Medical Group Senior |
$4.22
|
|
|
METHYLPREDNISOLONE 40 MG INJ. [4081204]
|
Facility
IP
|
$7.26
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
1720346
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.74 |
| Max. Negotiated Rate |
$6.17 |
| Rate for Payer: Blue Shield of California Commercial |
$5.17
|
| Rate for Payer: Blue Shield of California Commercial |
$5.20
|
| Rate for Payer: Blue Shield of California EPN |
$3.72
|
| Rate for Payer: Blue Shield of California EPN |
$3.74
|
| Rate for Payer: Cash Price |
$3.27
|
| Rate for Payer: Cash Price |
$3.29
|
| Rate for Payer: Cigna of CA HMO |
$5.08
|
| Rate for Payer: Cigna of CA HMO |
$5.11
|
| Rate for Payer: Cigna of CA PPO |
$5.11
|
| Rate for Payer: Cigna of CA PPO |
$5.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.92
|
| Rate for Payer: Galaxy Health WC |
$6.17
|
| Rate for Payer: Galaxy Health WC |
$6.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4.38
|
| Rate for Payer: Global Benefits Group Commercial |
$4.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.75
|
| Rate for Payer: Multiplan Commercial |
$5.81
|
| Rate for Payer: Multiplan Commercial |
$5.84
|
| Rate for Payer: Networks By Design Commercial |
$3.65
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Prime Health Services Commercial |
$6.20
|
| Rate for Payer: Prime Health Services Commercial |
$6.17
|
|
|
METHYLPREDNISOLONE 40 MG INJ. [4081204]
|
Facility
OP
|
$7.30
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
1720346
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.75 |
| Max. Negotiated Rate |
$26.34 |
| Rate for Payer: Dignity Health Medi-Cal |
$6.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.90
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.92
|
| Rate for Payer: Galaxy Health WC |
$6.20
|
| Rate for Payer: Galaxy Health WC |
$6.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$26.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3.99
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.99
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.01
|
| Rate for Payer: BCBS Transplant Transplant |
$4.38
|
| Rate for Payer: BCBS Transplant Transplant |
$4.36
|
| Rate for Payer: Blue Shield of California Commercial |
$5.35
|
| Rate for Payer: Blue Shield of California Commercial |
$5.38
|
| Rate for Payer: Blue Shield of California EPN |
$5.52
|
| Rate for Payer: Blue Shield of California EPN |
$5.52
|
| Rate for Payer: Cash Price |
$3.27
|
| Rate for Payer: Cash Price |
$3.29
|
| Rate for Payer: Cash Price |
$3.29
|
| Rate for Payer: Cash Price |
$3.27
|
| Rate for Payer: Cigna of CA HMO |
$5.11
|
| Rate for Payer: Cigna of CA HMO |
$5.08
|
| Rate for Payer: Cigna of CA PPO |
$5.08
|
| Rate for Payer: Cigna of CA PPO |
$5.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.20
|
| Rate for Payer: Dignity Health Media |
$6.17
|
| Rate for Payer: Dignity Health Media |
$6.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.20
|
| Rate for Payer: Global Benefits Group Commercial |
$4.36
|
| Rate for Payer: Global Benefits Group Commercial |
$4.38
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.48
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$5.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.84
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.75
|
| Rate for Payer: Multiplan Commercial |
$5.84
|
| Rate for Payer: Multiplan Commercial |
$5.81
|
| Rate for Payer: Networks By Design Commercial |
$3.63
|
| Rate for Payer: Networks By Design Commercial |
$3.65
|
| Rate for Payer: Prime Health Services Commercial |
$6.20
|
| Rate for Payer: Prime Health Services Commercial |
$6.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.36
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.63
|
| Rate for Payer: United Healthcare All Other HMO |
$3.63
|
| Rate for Payer: United Healthcare All Other HMO |
$3.65
|
| Rate for Payer: United Healthcare HMO Rider |
$3.63
|
| Rate for Payer: United Healthcare HMO Rider |
$3.65
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.65
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.17
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.17
|
| Rate for Payer: Vantage Medical Group Senior |
$6.17
|
| Rate for Payer: Vantage Medical Group Senior |
$6.20
|
|
|
METHYLPREDNISOLONE 4 MG TABLET [4993]
|
Facility
IP
|
$0.39
|
|
|
Service Code
|
CPT J7509
|
| Hospital Charge Code |
1710271
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.33 |
| Rate for Payer: Blue Shield of California Commercial |
$0.28
|
| Rate for Payer: Blue Shield of California Commercial |
$0.73
|
| Rate for Payer: Blue Shield of California Commercial |
$1.43
|
| Rate for Payer: Blue Shield of California Commercial |
$1.59
|
| Rate for Payer: Blue Shield of California EPN |
$0.53
|
| Rate for Payer: Blue Shield of California EPN |
$0.20
|
| Rate for Payer: Blue Shield of California EPN |
$1.03
|
| Rate for Payer: Blue Shield of California EPN |
$1.14
|
| Rate for Payer: Cash Price |
$0.46
|
| Rate for Payer: Cash Price |
$0.18
|
| Rate for Payer: Cash Price |
$0.90
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cigna of CA HMO |
$0.72
|
| Rate for Payer: Cigna of CA HMO |
$0.27
|
| Rate for Payer: Cigna of CA HMO |
$1.56
|
| Rate for Payer: Cigna of CA HMO |
$1.41
|
| Rate for Payer: Cigna of CA PPO |
$1.56
|
| Rate for Payer: Cigna of CA PPO |
$0.27
|
| Rate for Payer: Cigna of CA PPO |
$0.72
|
| Rate for Payer: Cigna of CA PPO |
$1.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.89
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.16
|
| Rate for Payer: Galaxy Health WC |
$0.33
|
| Rate for Payer: Galaxy Health WC |
$0.88
|
| Rate for Payer: Galaxy Health WC |
$1.71
|
| Rate for Payer: Galaxy Health WC |
$1.90
|
| Rate for Payer: Global Benefits Group Commercial |
$0.62
|
| Rate for Payer: Global Benefits Group Commercial |
$1.34
|
| Rate for Payer: Global Benefits Group Commercial |
$1.21
|
| Rate for Payer: Global Benefits Group Commercial |
$0.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.09
|
| Rate for Payer: Multiplan Commercial |
$0.82
|
| Rate for Payer: Multiplan Commercial |
$1.61
|
| Rate for Payer: Multiplan Commercial |
$0.31
|
| Rate for Payer: Multiplan Commercial |
$1.78
|
| Rate for Payer: Networks By Design Commercial |
$0.52
|
| Rate for Payer: Networks By Design Commercial |
$1.12
|
| Rate for Payer: Networks By Design Commercial |
$1.00
|
| Rate for Payer: Networks By Design Commercial |
$0.20
|
| Rate for Payer: Prime Health Services Commercial |
$1.90
|
| Rate for Payer: Prime Health Services Commercial |
$1.71
|
| Rate for Payer: Prime Health Services Commercial |
$0.88
|
| Rate for Payer: Prime Health Services Commercial |
$0.33
|
|
|
METHYLPREDNISOLONE 4 MG TABLET [4993]
|
Facility
OP
|
$1.03
|
|
|
Service Code
|
CPT J7509
|
| Hospital Charge Code |
1710271
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$1.43 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.88
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.90
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.71
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.57
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.21
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.11
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.57
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: BCBS Transplant Transplant |
$1.34
|
| Rate for Payer: BCBS Transplant Transplant |
$0.23
|
| Rate for Payer: BCBS Transplant Transplant |
$0.62
|
| Rate for Payer: BCBS Transplant Transplant |
$1.21
|
| Rate for Payer: Blue Shield of California Commercial |
$1.48
|
| Rate for Payer: Blue Shield of California Commercial |
$1.64
|
| Rate for Payer: Blue Shield of California Commercial |
$0.29
|
| Rate for Payer: Blue Shield of California Commercial |
$0.76
|
| Rate for Payer: Blue Shield of California EPN |
$1.17
|
| Rate for Payer: Blue Shield of California EPN |
$1.17
|
| Rate for Payer: Blue Shield of California EPN |
$1.17
|
| Rate for Payer: Blue Shield of California EPN |
$1.17
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$1.00
|
| Rate for Payer: Cash Price |
$0.18
|
| Rate for Payer: Cash Price |
$0.90
|
| Rate for Payer: Cash Price |
$0.46
|
| Rate for Payer: Cash Price |
$0.18
|
| Rate for Payer: Cash Price |
$0.46
|
| Rate for Payer: Cash Price |
$0.90
|
| Rate for Payer: Cigna of CA HMO |
$0.27
|
| Rate for Payer: Cigna of CA HMO |
$1.56
|
| Rate for Payer: Cigna of CA HMO |
$1.41
|
| Rate for Payer: Cigna of CA HMO |
$0.72
|
| Rate for Payer: Cigna of CA PPO |
$1.41
|
| Rate for Payer: Cigna of CA PPO |
$0.27
|
| Rate for Payer: Cigna of CA PPO |
$0.72
|
| Rate for Payer: Cigna of CA PPO |
$1.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.71
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.33
|
| Rate for Payer: Dignity Health Media |
$0.33
|
| Rate for Payer: Dignity Health Media |
$1.71
|
| Rate for Payer: Dignity Health Media |
$0.88
|
| Rate for Payer: Dignity Health Media |
$1.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.89
|
| Rate for Payer: Galaxy Health WC |
$0.88
|
| Rate for Payer: Galaxy Health WC |
$1.71
|
| Rate for Payer: Galaxy Health WC |
$0.33
|
| Rate for Payer: Galaxy Health WC |
$1.90
|
| Rate for Payer: Global Benefits Group Commercial |
$0.62
|
| Rate for Payer: Global Benefits Group Commercial |
$1.34
|
| Rate for Payer: Global Benefits Group Commercial |
$1.21
|
| Rate for Payer: Global Benefits Group Commercial |
$0.23
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.67
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.51
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.29
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.34
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.25
|
| Rate for Payer: Multiplan Commercial |
$1.78
|
| Rate for Payer: Multiplan Commercial |
$1.61
|
| Rate for Payer: Multiplan Commercial |
$0.82
|
| Rate for Payer: Multiplan Commercial |
$0.31
|
| Rate for Payer: Networks By Design Commercial |
$0.52
|
| Rate for Payer: Networks By Design Commercial |
$1.00
|
| Rate for Payer: Networks By Design Commercial |
$1.12
|
| Rate for Payer: Networks By Design Commercial |
$0.20
|
| Rate for Payer: Prime Health Services Commercial |
$0.33
|
| Rate for Payer: Prime Health Services Commercial |
$1.71
|
| Rate for Payer: Prime Health Services Commercial |
$0.88
|
| Rate for Payer: Prime Health Services Commercial |
$1.90
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO |
$1.12
|
| Rate for Payer: United Healthcare All Other HMO |
$1.00
|
| Rate for Payer: United Healthcare All Other HMO |
$0.52
|
| Rate for Payer: United Healthcare HMO Rider |
$0.20
|
| Rate for Payer: United Healthcare HMO Rider |
$0.52
|
| Rate for Payer: United Healthcare HMO Rider |
$1.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.71
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.33
|
| Rate for Payer: Vantage Medical Group Senior |
$0.88
|
| Rate for Payer: Vantage Medical Group Senior |
$0.33
|
| Rate for Payer: Vantage Medical Group Senior |
$1.71
|
| Rate for Payer: Vantage Medical Group Senior |
$1.90
|
|
|
METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [4991]
|
Facility
IP
|
$1.37
|
|
|
Service Code
|
CPT J7509
|
| Hospital Charge Code |
1711427
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$1.16 |
| Rate for Payer: Blue Shield of California Commercial |
$0.98
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California EPN |
$0.70
|
| Rate for Payer: Blue Shield of California EPN |
$0.19
|
| Rate for Payer: Cash Price |
$0.17
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: Cigna of CA HMO |
$0.26
|
| Rate for Payer: Cigna of CA HMO |
$0.96
|
| Rate for Payer: Cigna of CA PPO |
$0.96
|
| Rate for Payer: Cigna of CA PPO |
$0.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.55
|
| Rate for Payer: Galaxy Health WC |
$1.16
|
| Rate for Payer: Galaxy Health WC |
$0.31
|
| Rate for Payer: Global Benefits Group Commercial |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.09
|
| Rate for Payer: Multiplan Commercial |
$1.10
|
| Rate for Payer: Multiplan Commercial |
$0.30
|
| Rate for Payer: Networks By Design Commercial |
$0.19
|
| Rate for Payer: Networks By Design Commercial |
$0.69
|
| Rate for Payer: Prime Health Services Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$1.16
|
|
|
METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [4991]
|
Facility
OP
|
$0.37
|
|
|
Service Code
|
CPT J7509
|
| Hospital Charge Code |
1711427
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$1.43 |
| Rate for Payer: Vantage Medical Group Senior |
$0.31
|
| Rate for Payer: Vantage Medical Group Senior |
$1.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.16
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.75
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: BCBS Transplant Transplant |
$0.82
|
| Rate for Payer: BCBS Transplant Transplant |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.27
|
| Rate for Payer: Blue Shield of California EPN |
$1.17
|
| Rate for Payer: Blue Shield of California EPN |
$1.17
|
| Rate for Payer: Cash Price |
$0.17
|
| Rate for Payer: Cash Price |
$0.17
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: Cigna of CA HMO |
$0.96
|
| Rate for Payer: Cigna of CA HMO |
$0.26
|
| Rate for Payer: Cigna of CA PPO |
$0.26
|
| Rate for Payer: Cigna of CA PPO |
$0.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.16
|
| Rate for Payer: Dignity Health Media |
$0.31
|
| Rate for Payer: Dignity Health Media |
$1.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.55
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.15
|
| Rate for Payer: Galaxy Health WC |
$1.16
|
| Rate for Payer: Galaxy Health WC |
$0.31
|
| Rate for Payer: Global Benefits Group Commercial |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.82
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.03
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.09
|
| Rate for Payer: Multiplan Commercial |
$1.10
|
| Rate for Payer: Multiplan Commercial |
$0.30
|
| Rate for Payer: Networks By Design Commercial |
$0.19
|
| Rate for Payer: Networks By Design Commercial |
$0.69
|
| Rate for Payer: Prime Health Services Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$1.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.69
|
| Rate for Payer: United Healthcare All Other HMO |
$0.19
|
| Rate for Payer: United Healthcare All Other HMO |
$0.69
|
| Rate for Payer: United Healthcare HMO Rider |
$0.69
|
| Rate for Payer: United Healthcare HMO Rider |
$0.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.31
|
|
|
METHYLPREDNISOLONE 500 MG INJ WRAP FOR CNR USE ONLY [4081203]
|
Facility
OP
|
$29.14
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
ERX4081203
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$36.99 |
| Rate for Payer: Vantage Medical Group Senior |
$24.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$36.99
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$45.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.77
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$29.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$16.03
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$29.23
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.50
|
| Rate for Payer: BCBS Transplant Transplant |
$31.88
|
| Rate for Payer: BCBS Transplant Transplant |
$17.48
|
| Rate for Payer: Blue Shield of California Commercial |
$21.48
|
| Rate for Payer: Blue Shield of California Commercial |
$39.16
|
| Rate for Payer: Blue Shield of California EPN |
$8.51
|
| Rate for Payer: Blue Shield of California EPN |
$8.51
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$23.91
|
| Rate for Payer: Cash Price |
$23.91
|
| Rate for Payer: Cigna of CA HMO |
$37.20
|
| Rate for Payer: Cigna of CA HMO |
$20.40
|
| Rate for Payer: Cigna of CA PPO |
$37.20
|
| Rate for Payer: Cigna of CA PPO |
$20.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.17
|
| Rate for Payer: Dignity Health Media |
$24.77
|
| Rate for Payer: Dignity Health Media |
$45.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.66
|
| Rate for Payer: Galaxy Health WC |
$45.17
|
| Rate for Payer: Galaxy Health WC |
$24.77
|
| Rate for Payer: Global Benefits Group Commercial |
$17.48
|
| Rate for Payer: Global Benefits Group Commercial |
$31.88
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$39.86
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$21.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$23.31
|
| Rate for Payer: Multiplan Commercial |
$42.51
|
| Rate for Payer: Networks By Design Commercial |
$14.57
|
| Rate for Payer: Networks By Design Commercial |
$26.57
|
| Rate for Payer: Prime Health Services Commercial |
$24.77
|
| Rate for Payer: Prime Health Services Commercial |
$45.17
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$17.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$31.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$17.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$31.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$14.57
|
| Rate for Payer: United Healthcare All Other Commercial |
$26.57
|
| Rate for Payer: United Healthcare All Other HMO |
$26.57
|
| Rate for Payer: United Healthcare All Other HMO |
$14.57
|
| Rate for Payer: United Healthcare HMO Rider |
$26.57
|
| Rate for Payer: United Healthcare HMO Rider |
$14.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$14.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$24.77
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$45.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.17
|
| Rate for Payer: Vantage Medical Group Senior |
$45.17
|
|
|
METHYLPREDNISOLONE 500 MG INJ WRAP FOR CNR USE ONLY [4081203]
|
Facility
IP
|
$29.14
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
ERX4081203
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.99 |
| Max. Negotiated Rate |
$24.77 |
| Rate for Payer: Blue Shield of California Commercial |
$20.75
|
| Rate for Payer: Blue Shield of California Commercial |
$37.84
|
| Rate for Payer: Blue Shield of California EPN |
$14.92
|
| Rate for Payer: Blue Shield of California EPN |
$27.21
|
| Rate for Payer: Cash Price |
$23.91
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cigna of CA HMO |
$37.20
|
| Rate for Payer: Cigna of CA HMO |
$20.40
|
| Rate for Payer: Cigna of CA PPO |
$37.20
|
| Rate for Payer: Cigna of CA PPO |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$21.26
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.66
|
| Rate for Payer: Galaxy Health WC |
$45.17
|
| Rate for Payer: Galaxy Health WC |
$24.77
|
| Rate for Payer: Global Benefits Group Commercial |
$31.88
|
| Rate for Payer: Global Benefits Group Commercial |
$17.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$19.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$35.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.99
|
| Rate for Payer: Multiplan Commercial |
$23.31
|
| Rate for Payer: Multiplan Commercial |
$42.51
|
| Rate for Payer: Networks By Design Commercial |
$14.57
|
| Rate for Payer: Networks By Design Commercial |
$26.57
|
| Rate for Payer: Prime Health Services Commercial |
$24.77
|
| Rate for Payer: Prime Health Services Commercial |
$45.17
|
|
