|
CATH HDA TRAY 12.5FRX20CM
|
Facility
IP
|
$895.57
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698321
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$179.11 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California EPN |
$478.23
|
| Rate for Payer: Cash Price |
$403.01
|
| Rate for Payer: Cash Price |
$403.01
|
| Rate for Payer: Central Health Plan Commercial |
$716.46
|
| Rate for Payer: Cigna of CA HMO |
$626.90
|
| Rate for Payer: Cigna of CA PPO |
$626.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$358.23
|
| Rate for Payer: EPIC Health Plan Transplant |
$358.23
|
| Rate for Payer: Galaxy Health WC |
$761.23
|
| Rate for Payer: Global Benefits Group Commercial |
$537.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$806.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$597.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.11
|
| Rate for Payer: Multiplan Commercial |
$671.68
|
| Rate for Payer: Prime Health Services Commercial |
$761.23
|
|
|
CATH HDA TRAY 12.5FRX20CM
|
Facility
OP
|
$895.57
|
|
|
Service Code
|
CPT C1752
|
| Hospital Charge Code |
901698321
|
|
Hospital Revenue Code
|
278
|
| Min. Negotiated Rate |
$179.11 |
| Max. Negotiated Rate |
$2,180.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2,180.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$761.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$492.56
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$492.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$408.92
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$498.83
|
| Rate for Payer: BCBS Transplant Transplant |
$537.34
|
| Rate for Payer: Blue Shield of California Commercial |
$671.68
|
| Rate for Payer: Blue Shield of California EPN |
$487.19
|
| Rate for Payer: Cash Price |
$403.01
|
| Rate for Payer: Cash Price |
$403.01
|
| Rate for Payer: Central Health Plan Commercial |
$716.46
|
| Rate for Payer: Cigna of CA HMO |
$626.90
|
| Rate for Payer: Cigna of CA PPO |
$626.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$761.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$358.23
|
| Rate for Payer: EPIC Health Plan Transplant |
$358.23
|
| Rate for Payer: Galaxy Health WC |
$761.23
|
| Rate for Payer: Global Benefits Group Commercial |
$537.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$806.01
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$671.68
|
| Rate for Payer: IEHP medi-cal |
$313.45
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$597.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$179.11
|
| Rate for Payer: Multiplan Commercial |
$671.68
|
| Rate for Payer: Networks By Design Commercial |
$447.78
|
| Rate for Payer: Prime Health Services Commercial |
$761.23
|
| Rate for Payer: Riverside University Health MISP |
$358.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$537.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$537.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$447.78
|
| Rate for Payer: United Healthcare All Other HMO |
$447.78
|
| Rate for Payer: United Healthcare HMO Rider |
$447.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$447.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$761.23
|
| Rate for Payer: Vantage Medical Group Senior |
$761.23
|
|
|
Cautery of cervix; laser ablation
|
Facility
OP
|
$15,354.00
|
|
|
Service Code
|
CPT 57513
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$2,960.28 |
| Max. Negotiated Rate |
$15,354.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,906.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3,906.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5,779.00
|
| Rate for Payer: Blue Shield of California Commercial |
$4,121.55
|
| Rate for Payer: Blue Shield of California EPN |
$2,960.28
|
| Rate for Payer: Caremore Medicare Advantage |
$3,906.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5,859.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,273.34
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$3,906.18
|
| Rate for Payer: EPIC Health Plan Transplant |
$3,906.18
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,406.14
|
| Rate for Payer: IEHP medi-cal |
$6,445.20
|
| Rate for Payer: IEHP Medicare Advantage |
$3,906.18
|
| Rate for Payer: Innovage PACE Commercial |
$5,859.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3,906.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5,234.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5,234.28
|
| Rate for Payer: Prime Health Services Medicare |
$4,140.55
|
| Rate for Payer: Riverside University Health MISP |
$4,296.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$11,375.00
|
| Rate for Payer: United Healthcare All Other HMO |
$15,354.00
|
| Rate for Payer: United Healthcare HMO Rider |
$9,681.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8,852.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5,859.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,296.80
|
| Rate for Payer: Vantage Medical Group Senior |
$3,906.18
|
|
|
CEFACLOR 250 MG/5 ML ORAL SUSPENSION [9434]
|
Facility
OP
|
$1.40
|
|
|
Service Code
|
NDC 16571-071-12
|
| Hospital Charge Code |
NDG9434
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$1.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.85
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.77
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.77
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: BCBS Transplant Transplant |
$0.84
|
| Rate for Payer: Blue Shield of California Commercial |
$0.88
|
| Rate for Payer: Blue Shield of California EPN |
$0.68
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Central Health Plan Commercial |
$1.12
|
| Rate for Payer: Cigna of CA HMO |
$0.98
|
| Rate for Payer: Cigna of CA PPO |
$0.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.56
|
| Rate for Payer: Galaxy Health WC |
$1.19
|
| Rate for Payer: Global Benefits Group Commercial |
$0.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.05
|
| Rate for Payer: IEHP medi-cal |
$0.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Multiplan Commercial |
$1.05
|
| Rate for Payer: Networks By Design Commercial |
$0.91
|
| Rate for Payer: Prime Health Services Commercial |
$1.19
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.84
|
| Rate for Payer: Riverside University Health MISP |
$0.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.70
|
| Rate for Payer: United Healthcare All Other HMO |
$0.70
|
| Rate for Payer: United Healthcare HMO Rider |
$0.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.19
|
| Rate for Payer: Vantage Medical Group Senior |
$1.19
|
|
|
CEFACLOR 250 MG/5 ML ORAL SUSPENSION [9434]
|
Facility
IP
|
$1.40
|
|
|
Service Code
|
NDC 16571-071-12
|
| Hospital Charge Code |
NDG9434
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1.05
|
| Rate for Payer: Blue Shield of California EPN |
$0.75
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Cash Price |
$0.63
|
| Rate for Payer: Central Health Plan Commercial |
$1.12
|
| Rate for Payer: Cigna of CA HMO |
$0.98
|
| Rate for Payer: Cigna of CA PPO |
$0.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.56
|
| Rate for Payer: Galaxy Health WC |
$1.19
|
| Rate for Payer: Global Benefits Group Commercial |
$0.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Multiplan Commercial |
$1.05
|
| Rate for Payer: Networks By Design Commercial |
$0.91
|
| Rate for Payer: Prime Health Services Commercial |
$1.19
|
|
|
CEFACLOR 500 MG CAPSULE [9431]
|
Facility
IP
|
$2.86
|
|
|
Service Code
|
NDC 61442-172-30
|
| Hospital Charge Code |
1712040
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.57 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$2.14
|
| Rate for Payer: Blue Shield of California EPN |
$1.53
|
| Rate for Payer: Cash Price |
$1.29
|
| Rate for Payer: Cash Price |
$1.29
|
| Rate for Payer: Central Health Plan Commercial |
$2.29
|
| Rate for Payer: Cigna of CA HMO |
$2.00
|
| Rate for Payer: Cigna of CA PPO |
$2.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
| Rate for Payer: Galaxy Health WC |
$2.43
|
| Rate for Payer: Global Benefits Group Commercial |
$1.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.57
|
| Rate for Payer: Multiplan Commercial |
$2.14
|
| Rate for Payer: Networks By Design Commercial |
$1.86
|
| Rate for Payer: Prime Health Services Commercial |
$2.43
|
|
|
CEFACLOR 500 MG CAPSULE [9431]
|
Facility
OP
|
$2.86
|
|
|
Service Code
|
NDC 61442-172-30
|
| Hospital Charge Code |
1712040
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.57 |
| Max. Negotiated Rate |
$2.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.74
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2.43
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.57
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.69
|
| Rate for Payer: BCBS Transplant Transplant |
$1.72
|
| Rate for Payer: Blue Shield of California Commercial |
$1.80
|
| Rate for Payer: Blue Shield of California EPN |
$1.40
|
| Rate for Payer: Cash Price |
$1.29
|
| Rate for Payer: Central Health Plan Commercial |
$2.29
|
| Rate for Payer: Cigna of CA HMO |
$2.00
|
| Rate for Payer: Cigna of CA PPO |
$2.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.14
|
| Rate for Payer: Galaxy Health WC |
$2.43
|
| Rate for Payer: Global Benefits Group Commercial |
$1.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.57
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.14
|
| Rate for Payer: IEHP medi-cal |
$1.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.57
|
| Rate for Payer: Multiplan Commercial |
$2.14
|
| Rate for Payer: Networks By Design Commercial |
$1.86
|
| Rate for Payer: Prime Health Services Commercial |
$2.43
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1.72
|
| Rate for Payer: Riverside University Health MISP |
$1.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.43
|
| Rate for Payer: United Healthcare All Other HMO |
$1.43
|
| Rate for Payer: United Healthcare HMO Rider |
$1.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.43
|
| Rate for Payer: Vantage Medical Group Senior |
$2.43
|
|
|
CEFADROXIL 500 MG CAPSULE [9436]
|
Facility
OP
|
$0.71
|
|
|
Service Code
|
NDC 0093-3196-53
|
| Hospital Charge Code |
ERX9436
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$0.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.42
|
| Rate for Payer: BCBS Transplant Transplant |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.45
|
| Rate for Payer: Blue Shield of California EPN |
$0.35
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Central Health Plan Commercial |
$0.57
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.60
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.64
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.53
|
| Rate for Payer: IEHP medi-cal |
$0.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
| Rate for Payer: Multiplan Commercial |
$0.53
|
| Rate for Payer: Networks By Design Commercial |
$0.46
|
| Rate for Payer: Prime Health Services Commercial |
$0.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: Riverside University Health MISP |
$0.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.36
|
| Rate for Payer: United Healthcare All Other HMO |
$0.36
|
| Rate for Payer: United Healthcare HMO Rider |
$0.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.60
|
| Rate for Payer: Vantage Medical Group Senior |
$0.60
|
|
|
CEFADROXIL 500 MG CAPSULE [9436]
|
Facility
IP
|
$0.71
|
|
|
Service Code
|
NDC 68180-180-08
|
| Hospital Charge Code |
ERX9436
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$0.53
|
| Rate for Payer: Blue Shield of California EPN |
$0.38
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Central Health Plan Commercial |
$0.57
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.60
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
| Rate for Payer: Multiplan Commercial |
$0.53
|
| Rate for Payer: Networks By Design Commercial |
$0.46
|
| Rate for Payer: Prime Health Services Commercial |
$0.60
|
|
|
CEFADROXIL 500 MG CAPSULE [9436]
|
Facility
IP
|
$0.71
|
|
|
Service Code
|
NDC 0093-3196-53
|
| Hospital Charge Code |
ERX9436
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$0.53
|
| Rate for Payer: Blue Shield of California EPN |
$0.38
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Central Health Plan Commercial |
$0.57
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.60
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
| Rate for Payer: Multiplan Commercial |
$0.53
|
| Rate for Payer: Networks By Design Commercial |
$0.46
|
| Rate for Payer: Prime Health Services Commercial |
$0.60
|
|
|
CEFADROXIL 500 MG CAPSULE [9436]
|
Facility
OP
|
$0.71
|
|
|
Service Code
|
NDC 68180-180-08
|
| Hospital Charge Code |
ERX9436
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$0.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.60
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.39
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.34
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.42
|
| Rate for Payer: BCBS Transplant Transplant |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.45
|
| Rate for Payer: Blue Shield of California EPN |
$0.35
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Central Health Plan Commercial |
$0.57
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.60
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.64
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.53
|
| Rate for Payer: IEHP medi-cal |
$0.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
| Rate for Payer: Multiplan Commercial |
$0.53
|
| Rate for Payer: Networks By Design Commercial |
$0.46
|
| Rate for Payer: Prime Health Services Commercial |
$0.60
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: Riverside University Health MISP |
$0.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.36
|
| Rate for Payer: United Healthcare All Other HMO |
$0.36
|
| Rate for Payer: United Healthcare HMO Rider |
$0.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.60
|
| Rate for Payer: Vantage Medical Group Senior |
$0.60
|
|
|
CEFAZOLIN 10 GRAM SOLUTION FOR INJ (100MG/ML IVPB) [1446]
|
Facility
IP
|
$14.40
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1750334
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.88 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$10.80
|
| Rate for Payer: Blue Shield of California EPN |
$7.69
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Central Health Plan Commercial |
$11.52
|
| Rate for Payer: Cigna of CA HMO |
$10.08
|
| Rate for Payer: Cigna of CA PPO |
$10.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.76
|
| Rate for Payer: Galaxy Health WC |
$12.24
|
| Rate for Payer: Global Benefits Group Commercial |
$8.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: Multiplan Commercial |
$10.80
|
| Rate for Payer: Networks By Design Commercial |
$7.20
|
| Rate for Payer: Prime Health Services Commercial |
$12.24
|
|
|
CEFAZOLIN 10 GRAM SOLUTION FOR INJ (100MG/ML IVPB) [1446]
|
Facility
OP
|
$14.40
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1750334
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$12.96 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.24
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: BCBS Transplant Transplant |
$8.64
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Central Health Plan Commercial |
$11.52
|
| Rate for Payer: Cigna of CA HMO |
$10.08
|
| Rate for Payer: Cigna of CA PPO |
$10.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.76
|
| Rate for Payer: Galaxy Health WC |
$12.24
|
| Rate for Payer: Global Benefits Group Commercial |
$8.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.96
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$10.80
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: Multiplan Commercial |
$10.80
|
| Rate for Payer: Networks By Design Commercial |
$7.20
|
| Rate for Payer: Prime Health Services Commercial |
$12.24
|
| Rate for Payer: Riverside University Health MISP |
$5.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.20
|
| Rate for Payer: United Healthcare All Other HMO |
$7.20
|
| Rate for Payer: United Healthcare HMO Rider |
$7.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.24
|
| Rate for Payer: Vantage Medical Group Senior |
$12.24
|
|
|
CEFAZOLIN 10 MG/ML SERIAL DILUTION FOR MIXTURES [4080885]
|
Facility
IP
|
$2.09
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX4080885
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.23
|
| Rate for Payer: Blue Shield of California Commercial |
$1.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1.29
|
| Rate for Payer: Blue Shield of California EPN |
$1.03
|
| Rate for Payer: Blue Shield of California EPN |
$1.12
|
| Rate for Payer: Blue Shield of California EPN |
$0.88
|
| Rate for Payer: Blue Shield of California EPN |
$0.92
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Central Health Plan Commercial |
$1.38
|
| Rate for Payer: Central Health Plan Commercial |
$1.31
|
| Rate for Payer: Central Health Plan Commercial |
$1.67
|
| Rate for Payer: Central Health Plan Commercial |
$1.54
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA HMO |
$1.15
|
| Rate for Payer: Cigna of CA HMO |
$1.46
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.46
|
| Rate for Payer: Cigna of CA PPO |
$1.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Galaxy Health WC |
$1.39
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1.25
|
| Rate for Payer: Global Benefits Group Commercial |
$0.98
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: Multiplan Commercial |
$1.57
|
| Rate for Payer: Multiplan Commercial |
$1.23
|
| Rate for Payer: Multiplan Commercial |
$1.44
|
| Rate for Payer: Multiplan Commercial |
$1.29
|
| Rate for Payer: Networks By Design Commercial |
$0.82
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Networks By Design Commercial |
$1.04
|
| Rate for Payer: Prime Health Services Commercial |
$1.39
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
|
|
CEFAZOLIN 10 MG/ML SERIAL DILUTION FOR MIXTURES [4080885]
|
Facility
OP
|
$1.92
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX4080885
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$5.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.78
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.39
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: BCBS Transplant Transplant |
$1.03
|
| Rate for Payer: BCBS Transplant Transplant |
$0.98
|
| Rate for Payer: BCBS Transplant Transplant |
$1.25
|
| Rate for Payer: BCBS Transplant Transplant |
$1.15
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Central Health Plan Commercial |
$1.54
|
| Rate for Payer: Central Health Plan Commercial |
$1.38
|
| Rate for Payer: Central Health Plan Commercial |
$1.67
|
| Rate for Payer: Central Health Plan Commercial |
$1.31
|
| Rate for Payer: Cigna of CA HMO |
$1.46
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA HMO |
$1.15
|
| Rate for Payer: Cigna of CA PPO |
$1.46
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.84
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Galaxy Health WC |
$1.39
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Global Benefits Group Commercial |
$1.25
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Global Benefits Group Commercial |
$0.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.55
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.29
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.44
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.57
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.23
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.38
|
| Rate for Payer: Multiplan Commercial |
$1.29
|
| Rate for Payer: Multiplan Commercial |
$1.44
|
| Rate for Payer: Multiplan Commercial |
$1.57
|
| Rate for Payer: Multiplan Commercial |
$1.23
|
| Rate for Payer: Networks By Design Commercial |
$0.82
|
| Rate for Payer: Networks By Design Commercial |
$1.04
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
| Rate for Payer: Prime Health Services Commercial |
$1.39
|
| Rate for Payer: Riverside University Health MISP |
$0.77
|
| Rate for Payer: Riverside University Health MISP |
$0.66
|
| Rate for Payer: Riverside University Health MISP |
$0.84
|
| Rate for Payer: Riverside University Health MISP |
$0.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.82
|
| Rate for Payer: United Healthcare All Other HMO |
$0.86
|
| Rate for Payer: United Healthcare All Other HMO |
$0.96
|
| Rate for Payer: United Healthcare All Other HMO |
$1.04
|
| Rate for Payer: United Healthcare All Other HMO |
$0.82
|
| Rate for Payer: United Healthcare HMO Rider |
$0.82
|
| Rate for Payer: United Healthcare HMO Rider |
$1.04
|
| Rate for Payer: United Healthcare HMO Rider |
$0.86
|
| Rate for Payer: United Healthcare HMO Rider |
$0.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.78
|
| Rate for Payer: Vantage Medical Group Senior |
$1.46
|
| Rate for Payer: Vantage Medical Group Senior |
$1.63
|
| Rate for Payer: Vantage Medical Group Senior |
$1.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1.78
|
|
|
CEFAZOLIN 1 GRAM INJECTION (IM) [4080785]
|
Facility
OP
|
$1.92
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX4080785
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$5.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.46
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.63
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.39
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.90
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: BCBS Transplant Transplant |
$1.25
|
| Rate for Payer: BCBS Transplant Transplant |
$0.98
|
| Rate for Payer: BCBS Transplant Transplant |
$1.15
|
| Rate for Payer: BCBS Transplant Transplant |
$1.03
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Central Health Plan Commercial |
$1.31
|
| Rate for Payer: Central Health Plan Commercial |
$1.67
|
| Rate for Payer: Central Health Plan Commercial |
$1.38
|
| Rate for Payer: Central Health Plan Commercial |
$1.54
|
| Rate for Payer: Cigna of CA HMO |
$1.46
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA HMO |
$1.15
|
| Rate for Payer: Cigna of CA PPO |
$1.46
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.84
|
| Rate for Payer: Galaxy Health WC |
$1.39
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$0.98
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Global Benefits Group Commercial |
$1.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.73
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.23
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.44
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.29
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.57
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: Multiplan Commercial |
$1.44
|
| Rate for Payer: Multiplan Commercial |
$1.23
|
| Rate for Payer: Multiplan Commercial |
$1.29
|
| Rate for Payer: Multiplan Commercial |
$1.57
|
| Rate for Payer: Networks By Design Commercial |
$1.04
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Networks By Design Commercial |
$0.82
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
| Rate for Payer: Prime Health Services Commercial |
$1.39
|
| Rate for Payer: Riverside University Health MISP |
$0.77
|
| Rate for Payer: Riverside University Health MISP |
$0.84
|
| Rate for Payer: Riverside University Health MISP |
$0.69
|
| Rate for Payer: Riverside University Health MISP |
$0.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.04
|
| Rate for Payer: United Healthcare All Other HMO |
$1.04
|
| Rate for Payer: United Healthcare All Other HMO |
$0.86
|
| Rate for Payer: United Healthcare All Other HMO |
$0.96
|
| Rate for Payer: United Healthcare All Other HMO |
$0.82
|
| Rate for Payer: United Healthcare HMO Rider |
$0.86
|
| Rate for Payer: United Healthcare HMO Rider |
$1.04
|
| Rate for Payer: United Healthcare HMO Rider |
$0.82
|
| Rate for Payer: United Healthcare HMO Rider |
$0.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.82
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.78
|
| Rate for Payer: Vantage Medical Group Senior |
$1.39
|
| Rate for Payer: Vantage Medical Group Senior |
$1.46
|
| Rate for Payer: Vantage Medical Group Senior |
$1.78
|
| Rate for Payer: Vantage Medical Group Senior |
$1.63
|
|
|
CEFAZOLIN 1 GRAM INJECTION (IM) [4080785]
|
Facility
IP
|
$1.72
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX4080785
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1.57
|
| Rate for Payer: Blue Shield of California Commercial |
$1.29
|
| Rate for Payer: Blue Shield of California Commercial |
$1.23
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California EPN |
$0.88
|
| Rate for Payer: Blue Shield of California EPN |
$0.92
|
| Rate for Payer: Blue Shield of California EPN |
$1.12
|
| Rate for Payer: Blue Shield of California EPN |
$1.03
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.74
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Central Health Plan Commercial |
$1.31
|
| Rate for Payer: Central Health Plan Commercial |
$1.67
|
| Rate for Payer: Central Health Plan Commercial |
$1.38
|
| Rate for Payer: Central Health Plan Commercial |
$1.54
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$1.46
|
| Rate for Payer: Cigna of CA HMO |
$1.15
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.46
|
| Rate for Payer: Cigna of CA PPO |
$1.15
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.84
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Galaxy Health WC |
$1.39
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$0.98
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Global Benefits Group Commercial |
$1.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.39
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.38
|
| Rate for Payer: Multiplan Commercial |
$1.29
|
| Rate for Payer: Multiplan Commercial |
$1.57
|
| Rate for Payer: Multiplan Commercial |
$1.23
|
| Rate for Payer: Multiplan Commercial |
$1.44
|
| Rate for Payer: Networks By Design Commercial |
$1.04
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Networks By Design Commercial |
$0.82
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
| Rate for Payer: Prime Health Services Commercial |
$1.39
|
|
|
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [1445]
|
Facility
IP
|
$1.72
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1720430
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1.29
|
| Rate for Payer: Blue Shield of California EPN |
$0.92
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Central Health Plan Commercial |
$1.38
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.55
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: Multiplan Commercial |
$1.29
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
|
|
CEFAZOLIN 1 GRAM SOLUTION FOR INJECTION [1445]
|
Facility
OP
|
$1.72
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1720430
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$5.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.46
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: BCBS Transplant Transplant |
$1.03
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Central Health Plan Commercial |
$1.38
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.69
|
| Rate for Payer: Galaxy Health WC |
$1.46
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.55
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.29
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: Multiplan Commercial |
$1.29
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Prime Health Services Commercial |
$1.46
|
| Rate for Payer: Riverside University Health MISP |
$0.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.86
|
| Rate for Payer: United Healthcare All Other HMO |
$0.86
|
| Rate for Payer: United Healthcare HMO Rider |
$0.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.46
|
| Rate for Payer: Vantage Medical Group Senior |
$1.46
|
|
|
CEFAZOLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK [154193]
|
Facility
IP
|
$17.71
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1753550
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$13.28
|
| Rate for Payer: Blue Shield of California EPN |
$9.46
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: Central Health Plan Commercial |
$14.17
|
| Rate for Payer: Cigna of CA HMO |
$12.40
|
| Rate for Payer: Cigna of CA PPO |
$12.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.08
|
| Rate for Payer: Galaxy Health WC |
$15.05
|
| Rate for Payer: Global Benefits Group Commercial |
$10.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.54
|
| Rate for Payer: Multiplan Commercial |
$13.28
|
| Rate for Payer: Networks By Design Commercial |
$8.86
|
| Rate for Payer: Prime Health Services Commercial |
$15.05
|
|
|
CEFAZOLIN 2 GRAM/50 ML IN DEXTROSE (ISO-OSMOTIC) INTRAVENOUS PIGGYBACK [154193]
|
Facility
OP
|
$17.71
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1753550
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$15.94 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$15.05
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$9.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: BCBS Transplant Transplant |
$10.63
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: Cash Price |
$7.97
|
| Rate for Payer: Central Health Plan Commercial |
$14.17
|
| Rate for Payer: Cigna of CA HMO |
$12.40
|
| Rate for Payer: Cigna of CA PPO |
$12.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.08
|
| Rate for Payer: Galaxy Health WC |
$15.05
|
| Rate for Payer: Global Benefits Group Commercial |
$10.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.94
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$13.28
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.54
|
| Rate for Payer: Multiplan Commercial |
$13.28
|
| Rate for Payer: Networks By Design Commercial |
$8.86
|
| Rate for Payer: Prime Health Services Commercial |
$15.05
|
| Rate for Payer: Riverside University Health MISP |
$7.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.86
|
| Rate for Payer: United Healthcare All Other HMO |
$8.86
|
| Rate for Payer: United Healthcare HMO Rider |
$8.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.05
|
| Rate for Payer: Vantage Medical Group Senior |
$15.05
|
|
|
CEFAZOLIN 300 G SOLUTION FOR INJECTION [31087]
|
Facility
OP
|
$366.00
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX31087
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$329.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$311.10
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$201.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$201.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: BCBS Transplant Transplant |
$219.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Central Health Plan Commercial |
$292.80
|
| Rate for Payer: Cigna of CA HMO |
$256.20
|
| Rate for Payer: Cigna of CA PPO |
$256.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$311.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$146.40
|
| Rate for Payer: Galaxy Health WC |
$311.10
|
| Rate for Payer: Global Benefits Group Commercial |
$219.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$329.40
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$274.50
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$244.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.20
|
| Rate for Payer: Multiplan Commercial |
$274.50
|
| Rate for Payer: Networks By Design Commercial |
$183.00
|
| Rate for Payer: Prime Health Services Commercial |
$311.10
|
| Rate for Payer: Riverside University Health MISP |
$146.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$219.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$219.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$183.00
|
| Rate for Payer: United Healthcare All Other HMO |
$183.00
|
| Rate for Payer: United Healthcare HMO Rider |
$183.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$183.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$311.10
|
| Rate for Payer: Vantage Medical Group Senior |
$311.10
|
|
|
CEFAZOLIN 300 G SOLUTION FOR INJECTION [31087]
|
Facility
IP
|
$366.00
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
ERX31087
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$73.20 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$274.50
|
| Rate for Payer: Blue Shield of California EPN |
$195.44
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Cash Price |
$164.70
|
| Rate for Payer: Central Health Plan Commercial |
$292.80
|
| Rate for Payer: Cigna of CA HMO |
$256.20
|
| Rate for Payer: Cigna of CA PPO |
$256.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$146.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$146.40
|
| Rate for Payer: Galaxy Health WC |
$311.10
|
| Rate for Payer: Global Benefits Group Commercial |
$219.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$329.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$244.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$73.20
|
| Rate for Payer: Multiplan Commercial |
$274.50
|
| Rate for Payer: Networks By Design Commercial |
$183.00
|
| Rate for Payer: Prime Health Services Commercial |
$311.10
|
|
|
CEFAZOLIN 500 MG SOLUTION FOR INJECTION [1448]
|
Facility
OP
|
$1.68
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1720629
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$5.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.72
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.63
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.90
|
| Rate for Payer: BCBS Transplant Transplant |
$1.01
|
| Rate for Payer: BCBS Transplant Transplant |
$1.15
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Blue Shield of California EPN |
$2.16
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.76
|
| Rate for Payer: Cash Price |
$0.76
|
| Rate for Payer: Central Health Plan Commercial |
$1.34
|
| Rate for Payer: Central Health Plan Commercial |
$1.54
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$1.18
|
| Rate for Payer: Cigna of CA PPO |
$1.18
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: Galaxy Health WC |
$1.43
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.51
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.26
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.44
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: IEHP medi-cal |
$0.82
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.38
|
| Rate for Payer: Multiplan Commercial |
$1.26
|
| Rate for Payer: Multiplan Commercial |
$1.44
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Networks By Design Commercial |
$0.84
|
| Rate for Payer: Prime Health Services Commercial |
$1.43
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
| Rate for Payer: Riverside University Health MISP |
$0.77
|
| Rate for Payer: Riverside University Health MISP |
$0.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.01
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.96
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.84
|
| Rate for Payer: United Healthcare All Other HMO |
$0.84
|
| Rate for Payer: United Healthcare All Other HMO |
$0.96
|
| Rate for Payer: United Healthcare HMO Rider |
$0.96
|
| Rate for Payer: United Healthcare HMO Rider |
$0.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.63
|
| Rate for Payer: Vantage Medical Group Senior |
$1.43
|
| Rate for Payer: Vantage Medical Group Senior |
$1.63
|
|
|
CEFAZOLIN 500 MG SOLUTION FOR INJECTION [1448]
|
Facility
IP
|
$1.92
|
|
|
Service Code
|
CPT J0690
|
| Hospital Charge Code |
1720629
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.38 |
| Max. Negotiated Rate |
$34,005.88 |
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34,005.88
|
| Rate for Payer: Blue Shield of California Commercial |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.26
|
| Rate for Payer: Blue Shield of California EPN |
$0.90
|
| Rate for Payer: Blue Shield of California EPN |
$1.03
|
| Rate for Payer: Cash Price |
$0.76
|
| Rate for Payer: Cash Price |
$0.76
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Cash Price |
$0.86
|
| Rate for Payer: Central Health Plan Commercial |
$1.34
|
| Rate for Payer: Central Health Plan Commercial |
$1.54
|
| Rate for Payer: Cigna of CA HMO |
$1.18
|
| Rate for Payer: Cigna of CA HMO |
$1.34
|
| Rate for Payer: Cigna of CA PPO |
$1.18
|
| Rate for Payer: Cigna of CA PPO |
$1.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.77
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.67
|
| Rate for Payer: Galaxy Health WC |
$1.43
|
| Rate for Payer: Galaxy Health WC |
$1.63
|
| Rate for Payer: Global Benefits Group Commercial |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$1.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: Multiplan Commercial |
$1.26
|
| Rate for Payer: Multiplan Commercial |
$1.44
|
| Rate for Payer: Networks By Design Commercial |
$0.84
|
| Rate for Payer: Networks By Design Commercial |
$0.96
|
| Rate for Payer: Prime Health Services Commercial |
$1.43
|
| Rate for Payer: Prime Health Services Commercial |
$1.63
|
|
