|
POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$35,350.37
|
|
|
Service Code
|
APR-DRG 7113
|
| Min. Negotiated Rate |
$27,117.46 |
| Max. Negotiated Rate |
$35,350.37 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$27,117.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$35,350.37
|
|
|
POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$16,360.18
|
|
|
Service Code
|
APR-DRG 7111
|
| Min. Negotiated Rate |
$12,549.98 |
| Max. Negotiated Rate |
$16,360.18 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$12,549.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16,360.18
|
|
|
POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
|
IP
|
$32,464.96
|
|
|
Service Code
|
APR-DRG 7214
|
| Min. Negotiated Rate |
$24,904.04 |
| Max. Negotiated Rate |
$32,464.96 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$24,904.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$32,464.96
|
|
|
POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
|
IP
|
$18,119.44
|
|
|
Service Code
|
APR-DRG 7213
|
| Min. Negotiated Rate |
$13,899.52 |
| Max. Negotiated Rate |
$18,119.44 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$13,899.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18,119.44
|
|
|
POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
|
IP
|
$8,718.32
|
|
|
Service Code
|
APR-DRG 7211
|
| Min. Negotiated Rate |
$6,687.87 |
| Max. Negotiated Rate |
$8,718.32 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$6,687.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$8,718.32
|
|
|
POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS
|
Facility
|
IP
|
$11,488.48
|
|
|
Service Code
|
APR-DRG 7212
|
| Min. Negotiated Rate |
$8,812.88 |
| Max. Negotiated Rate |
$11,488.48 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8,812.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$11,488.48
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
|
IP
|
$5,896.76
|
|
|
Service Code
|
APR-DRG 5612
|
| Min. Negotiated Rate |
$4,523.44 |
| Max. Negotiated Rate |
$5,896.76 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,523.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5,896.76
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
|
IP
|
$3,883.88
|
|
|
Service Code
|
APR-DRG 5611
|
| Min. Negotiated Rate |
$2,979.35 |
| Max. Negotiated Rate |
$3,883.88 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$2,979.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3,883.88
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
|
IP
|
$21,437.42
|
|
|
Service Code
|
APR-DRG 5614
|
| Min. Negotiated Rate |
$16,444.75 |
| Max. Negotiated Rate |
$21,437.42 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$16,444.75
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21,437.42
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE
|
Facility
|
IP
|
$9,221.99
|
|
|
Service Code
|
APR-DRG 5613
|
| Min. Negotiated Rate |
$7,074.24 |
| Max. Negotiated Rate |
$9,221.99 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$7,074.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9,221.99
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$56,251.50
|
|
|
Service Code
|
APR-DRG 5484
|
| Min. Negotiated Rate |
$43,150.82 |
| Max. Negotiated Rate |
$56,251.50 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$43,150.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$56,251.50
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$6,466.04
|
|
|
Service Code
|
APR-DRG 5481
|
| Min. Negotiated Rate |
$4,960.13 |
| Max. Negotiated Rate |
$6,466.04 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$4,960.13
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6,466.04
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$22,397.03
|
|
|
Service Code
|
APR-DRG 5483
|
| Min. Negotiated Rate |
$17,180.88 |
| Max. Negotiated Rate |
$22,397.03 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$17,180.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$22,397.03
|
|
|
POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$13,407.35
|
|
|
Service Code
|
APR-DRG 5482
|
| Min. Negotiated Rate |
$10,284.85 |
| Max. Negotiated Rate |
$13,407.35 |
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$10,284.85
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13,407.35
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
IP
|
$0.26
|
|
|
Service Code
|
NDC 0409-3294-51
|
| Hospital Charge Code |
NDG6420B
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.22 |
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.13
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.21
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
IP
|
$0.26
|
|
|
Service Code
|
NDC 51754-2004-1
|
| Hospital Charge Code |
ERX6420
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.22 |
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.13
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.21
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
OP
|
$0.26
|
|
|
Service Code
|
NDC 51754-2004-1
|
| Hospital Charge Code |
ERX6420
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.15
|
| Rate for Payer: Blue Distinction Transplant |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.15
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cigna of CA HMO |
$0.17
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.22
|
| Rate for Payer: Dignity Health Media |
$0.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.21
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
| Rate for Payer: United Healthcare All Other HMO |
$0.13
|
| Rate for Payer: United Healthcare HMO Rider |
$0.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.22
|
| Rate for Payer: Vantage Medical Group Senior |
$0.22
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
IP
|
$0.21
|
|
|
Service Code
|
NDC 0409-8183-11
|
| Hospital Charge Code |
NDG6420A
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.18 |
| Rate for Payer: Blue Shield of California Commercial |
$0.15
|
| Rate for Payer: Blue Shield of California EPN |
$0.11
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.18
|
| Rate for Payer: Global Benefits Group Commercial |
$0.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Prime Health Services Commercial |
$0.18
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
IP
|
$0.21
|
|
|
Service Code
|
NDC 0409-8183-01
|
| Hospital Charge Code |
NDG6420A
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.18 |
| Rate for Payer: Blue Shield of California Commercial |
$0.15
|
| Rate for Payer: Blue Shield of California EPN |
$0.11
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.18
|
| Rate for Payer: Global Benefits Group Commercial |
$0.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Prime Health Services Commercial |
$0.18
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
IP
|
$0.32
|
|
|
Service Code
|
NDC 51754-2001-4
|
| Hospital Charge Code |
NDG6420A
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$0.27 |
| Rate for Payer: Blue Shield of California Commercial |
$0.23
|
| Rate for Payer: Blue Shield of California EPN |
$0.16
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.13
|
| Rate for Payer: Galaxy Health WC |
$0.27
|
| Rate for Payer: Global Benefits Group Commercial |
$0.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.08
|
| Rate for Payer: Multiplan Commercial |
$0.26
|
| Rate for Payer: Networks By Design Commercial |
$0.21
|
| Rate for Payer: Prime Health Services Commercial |
$0.27
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
IP
|
$0.26
|
|
|
Service Code
|
NDC 0409-3294-61
|
| Hospital Charge Code |
NDG6420B
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.22 |
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.13
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.21
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
OP
|
$0.21
|
|
|
Service Code
|
NDC 0409-8183-11
|
| Hospital Charge Code |
NDG6420A
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.13
|
| Rate for Payer: Blue Distinction Transplant |
$0.13
|
| Rate for Payer: Blue Shield of California Commercial |
$0.15
|
| Rate for Payer: Blue Shield of California EPN |
$0.12
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cigna of CA HMO |
$0.13
|
| Rate for Payer: Cigna of CA PPO |
$0.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.18
|
| Rate for Payer: Dignity Health Media |
$0.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.18
|
| Rate for Payer: Global Benefits Group Commercial |
$0.13
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Prime Health Services Commercial |
$0.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.18
|
| Rate for Payer: Vantage Medical Group Senior |
$0.18
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
OP
|
$0.26
|
|
|
Service Code
|
NDC 0409-3294-61
|
| Hospital Charge Code |
NDG6420B
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.15
|
| Rate for Payer: Blue Distinction Transplant |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.15
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cigna of CA HMO |
$0.17
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.22
|
| Rate for Payer: Dignity Health Media |
$0.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.21
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
| Rate for Payer: United Healthcare All Other HMO |
$0.13
|
| Rate for Payer: United Healthcare HMO Rider |
$0.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.22
|
| Rate for Payer: Vantage Medical Group Senior |
$0.22
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
OP
|
$0.21
|
|
|
Service Code
|
NDC 0409-8183-01
|
| Hospital Charge Code |
NDG6420A
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.18 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.13
|
| Rate for Payer: Blue Distinction Transplant |
$0.13
|
| Rate for Payer: Blue Shield of California Commercial |
$0.15
|
| Rate for Payer: Blue Shield of California EPN |
$0.12
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cigna of CA HMO |
$0.13
|
| Rate for Payer: Cigna of CA PPO |
$0.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.18
|
| Rate for Payer: Dignity Health Media |
$0.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.18
|
| Rate for Payer: Global Benefits Group Commercial |
$0.13
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Prime Health Services Commercial |
$0.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.18
|
| Rate for Payer: Vantage Medical Group Senior |
$0.18
|
|
|
POTASSIUM ACETATE 2 MEQ/ML INTRAVENOUS SOLUTION [6420]
|
Facility
|
OP
|
$0.32
|
|
|
Service Code
|
NDC 51754-2001-4
|
| Hospital Charge Code |
NDG6420A
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$0.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.19
|
| Rate for Payer: Blue Distinction Transplant |
$0.19
|
| Rate for Payer: Blue Shield of California Commercial |
$0.24
|
| Rate for Payer: Blue Shield of California EPN |
$0.19
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Cigna of CA HMO |
$0.20
|
| Rate for Payer: Cigna of CA PPO |
$0.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.27
|
| Rate for Payer: Dignity Health Media |
$0.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.13
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.13
|
| Rate for Payer: Galaxy Health WC |
$0.27
|
| Rate for Payer: Global Benefits Group Commercial |
$0.19
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.08
|
| Rate for Payer: Multiplan Commercial |
$0.26
|
| Rate for Payer: Networks By Design Commercial |
$0.21
|
| Rate for Payer: Prime Health Services Commercial |
$0.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.16
|
| Rate for Payer: United Healthcare All Other HMO |
$0.16
|
| Rate for Payer: United Healthcare HMO Rider |
$0.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.27
|
| Rate for Payer: Vantage Medical Group Senior |
$0.27
|
|
