|
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS
|
Facility
|
IP
|
$6,697.18
|
|
|
Service Code
|
APR-DRG 5321
|
| Min. Negotiated Rate |
$4,229.80 |
| Max. Negotiated Rate |
$6,697.18 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,229.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,040.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,697.18
|
|
|
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS
|
Facility
|
IP
|
$13,102.31
|
|
|
Service Code
|
APR-DRG 5323
|
| Min. Negotiated Rate |
$8,275.14 |
| Max. Negotiated Rate |
$13,102.31 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,275.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,861.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13,102.31
|
|
|
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS
|
Facility
|
IP
|
$21,761.31
|
|
|
Service Code
|
APR-DRG 5324
|
| Min. Negotiated Rate |
$13,743.98 |
| Max. Negotiated Rate |
$21,761.31 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,743.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16,378.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21,761.31
|
|
|
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS
|
Facility
|
IP
|
$9,063.85
|
|
|
Service Code
|
APR-DRG 5322
|
| Min. Negotiated Rate |
$5,724.54 |
| Max. Negotiated Rate |
$9,063.85 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,724.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,821.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,063.85
|
|
|
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC
|
Facility
|
IP
|
$26,516.39
|
|
|
Service Code
|
MSDRG 760
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$26,516.39 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,516.39
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,128.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,980.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,415.22
|
| Rate for Payer: EPIC Health Plan Senior |
$16,276.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,797.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,715.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,828.11
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,797.10
|
| Rate for Payer: Prime Health Services Medicare |
$15,684.93
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC
|
Facility
|
IP
|
$14,991.30
|
|
|
Service Code
|
MSDRG 761
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$14,991.30 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14,991.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,683.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$13,557.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$14,470.45
|
| Rate for Payer: EPIC Health Plan Senior |
$9,646.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,769.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$12,277.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11,751.76
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,769.97
|
| Rate for Payer: Prime Health Services Medicare |
$9,296.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$20,726.02
|
|
|
Service Code
|
APR-DRG 7402
|
| Min. Negotiated Rate |
$13,090.12 |
| Max. Negotiated Rate |
$20,726.02 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,090.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15,599.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$20,726.02
|
|
|
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$12,109.31
|
|
|
Service Code
|
APR-DRG 7401
|
| Min. Negotiated Rate |
$7,647.98 |
| Max. Negotiated Rate |
$12,109.31 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,647.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,113.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12,109.31
|
|
|
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$37,121.52
|
|
|
Service Code
|
APR-DRG 7403
|
| Min. Negotiated Rate |
$23,445.17 |
| Max. Negotiated Rate |
$37,121.52 |
| Rate for Payer: Adventist Health Medi-Cal |
$23,445.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27,938.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37,121.52
|
|
|
MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE
|
Facility
|
IP
|
$86,515.51
|
|
|
Service Code
|
APR-DRG 7404
|
| Min. Negotiated Rate |
$54,641.38 |
| Max. Negotiated Rate |
$86,515.51 |
| Rate for Payer: Adventist Health Medi-Cal |
$54,641.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$65,114.31
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$86,515.51
|
|
|
MENTHOL 0.44 %-ZINC OXIDE 20.6 % TOPICAL OINTMENT [91352]
|
Facility
|
IP
|
$0.04
|
|
|
Service Code
|
NDC 1013570104
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.04 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.03
|
| Rate for Payer: Blue Shield of California EPN |
$0.02
|
| Rate for Payer: Cash Price |
$0.02
|
| Rate for Payer: Central Health Plan Commercial |
$0.03
|
| Rate for Payer: Cigna of CA HMO |
$0.03
|
| Rate for Payer: Cigna of CA PPO |
$0.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
| Rate for Payer: EPIC Health Plan Senior |
$0.02
|
| Rate for Payer: Galaxy Health WC |
$0.03
|
| Rate for Payer: Global Benefits Group Commercial |
$0.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.03
|
| Rate for Payer: Networks By Design Commercial |
$0.03
|
| Rate for Payer: Prime Health Services Commercial |
$0.03
|
|
|
MENTHOL 0.44 %-ZINC OXIDE 20.6 % TOPICAL OINTMENT [91352]
|
Facility
|
OP
|
$0.04
|
|
|
Service Code
|
NDC 1013570104
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.04 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.03
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.02
|
| Rate for Payer: Blue Shield of California Commercial |
$0.03
|
| Rate for Payer: Blue Shield of California EPN |
$0.02
|
| Rate for Payer: Cash Price |
$0.02
|
| Rate for Payer: Central Health Plan Commercial |
$0.03
|
| Rate for Payer: Cigna of CA HMO |
$0.03
|
| Rate for Payer: Cigna of CA PPO |
$0.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.03
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.03
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.03
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
| Rate for Payer: EPIC Health Plan Senior |
$0.02
|
| Rate for Payer: Galaxy Health WC |
$0.03
|
| Rate for Payer: Global Benefits Group Commercial |
$0.02
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.03
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.03
|
| Rate for Payer: Multiplan Commercial |
$0.03
|
| Rate for Payer: Networks By Design Commercial |
$0.03
|
| Rate for Payer: Prime Health Services Commercial |
$0.03
|
| Rate for Payer: Riverside University Health System MISP |
$0.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.02
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.02
|
| Rate for Payer: United Healthcare All Other HMO |
$0.02
|
| Rate for Payer: United Healthcare HMO Rider |
$0.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.03
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.03
|
| Rate for Payer: Vantage Medical Group Senior |
$0.03
|
|
|
MENTHOL 0.44 %-ZINC OXIDE 20.6 % TOPICAL OINTMENT IN PACKET [197109]
|
Facility
|
IP
|
$0.14
|
|
|
Service Code
|
NDC 0799000105
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.13 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Blue Shield of California Commercial |
$0.11
|
| Rate for Payer: Blue Shield of California EPN |
$0.07
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.11
|
| Rate for Payer: Cigna of CA HMO |
$0.10
|
| Rate for Payer: Cigna of CA PPO |
$0.10
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.06
|
| Rate for Payer: EPIC Health Plan Senior |
$0.06
|
| Rate for Payer: Galaxy Health WC |
$0.12
|
| Rate for Payer: Global Benefits Group Commercial |
$0.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
| Rate for Payer: Networks By Design Commercial |
$0.09
|
| Rate for Payer: Prime Health Services Commercial |
$0.12
|
|
|
MENTHOL 0.44 %-ZINC OXIDE 20.6 % TOPICAL OINTMENT IN PACKET [197109]
|
Facility
|
OP
|
$0.14
|
|
|
Service Code
|
NDC 0799000105
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.13 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.08
|
| Rate for Payer: Blue Shield of California Commercial |
$0.09
|
| Rate for Payer: Blue Shield of California EPN |
$0.06
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.11
|
| Rate for Payer: Cigna of CA HMO |
$0.10
|
| Rate for Payer: Cigna of CA PPO |
$0.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.06
|
| Rate for Payer: EPIC Health Plan Senior |
$0.06
|
| Rate for Payer: Galaxy Health WC |
$0.12
|
| Rate for Payer: Global Benefits Group Commercial |
$0.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.10
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
| Rate for Payer: Networks By Design Commercial |
$0.09
|
| Rate for Payer: Prime Health Services Commercial |
$0.12
|
| Rate for Payer: Riverside University Health System MISP |
$0.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.07
|
| Rate for Payer: United Healthcare All Other HMO |
$0.07
|
| Rate for Payer: United Healthcare HMO Rider |
$0.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.12
|
| Rate for Payer: Vantage Medical Group Senior |
$0.12
|
|
|
MEPERIDINE 50 MG/ML INJECTION SOLUTION [110376]
|
Facility
|
IP
|
$32.77
|
|
|
Service Code
|
HCPCS J2175
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.55 |
| Max. Negotiated Rate |
$29.49 |
| Rate for Payer: Adventist Health Commercial |
$6.55
|
| Rate for Payer: Blue Shield of California Commercial |
$26.28
|
| Rate for Payer: Blue Shield of California EPN |
$16.52
|
| Rate for Payer: Cash Price |
$14.75
|
| Rate for Payer: Central Health Plan Commercial |
$26.22
|
| Rate for Payer: Cigna of CA HMO |
$22.94
|
| Rate for Payer: Cigna of CA PPO |
$22.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.11
|
| Rate for Payer: EPIC Health Plan Senior |
$13.11
|
| Rate for Payer: Galaxy Health WC |
$27.85
|
| Rate for Payer: Global Benefits Group Commercial |
$19.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.49
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.55
|
| Rate for Payer: Multiplan Commercial |
$24.58
|
| Rate for Payer: Networks By Design Commercial |
$16.39
|
| Rate for Payer: Prime Health Services Commercial |
$27.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.30
|
| Rate for Payer: United Healthcare All Other HMO |
$11.97
|
| Rate for Payer: United Healthcare HMO Rider |
$11.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.73
|
|
|
MEPERIDINE 50 MG/ML INJECTION SOLUTION [110376]
|
Facility
|
OP
|
$32.77
|
|
|
Service Code
|
HCPCS J2175
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$62.83 |
| Rate for Payer: Adventist Health Commercial |
$6.55
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$27.85
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$24.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$8.06
|
| Rate for Payer: Blue Shield of California EPN |
$7.33
|
| Rate for Payer: Cash Price |
$14.75
|
| Rate for Payer: Cash Price |
$14.75
|
| Rate for Payer: Central Health Plan Commercial |
$26.22
|
| Rate for Payer: Cigna of CA HMO |
$22.94
|
| Rate for Payer: Cigna of CA PPO |
$22.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$27.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$27.85
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.85
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$22.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.11
|
| Rate for Payer: EPIC Health Plan Senior |
$13.11
|
| Rate for Payer: Galaxy Health WC |
$27.85
|
| Rate for Payer: Global Benefits Group Commercial |
$19.66
|
| Rate for Payer: Health Management Network EPO/PPO |
$29.49
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$20.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.55
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22.94
|
| Rate for Payer: Multiplan Commercial |
$24.58
|
| Rate for Payer: Networks By Design Commercial |
$16.39
|
| Rate for Payer: Prime Health Services Commercial |
$27.85
|
| Rate for Payer: Riverside University Health System MISP |
$13.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$19.66
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$19.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.30
|
| Rate for Payer: United Healthcare All Other HMO |
$11.97
|
| Rate for Payer: United Healthcare HMO Rider |
$11.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$10.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$27.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$27.85
|
| Rate for Payer: Vantage Medical Group Senior |
$27.85
|
|
|
MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION [117787]
|
Facility
|
IP
|
$3.04
|
|
|
Service Code
|
HCPCS J2175
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$2.74 |
| Rate for Payer: Adventist Health Commercial |
$0.61
|
| Rate for Payer: Blue Shield of California Commercial |
$2.44
|
| Rate for Payer: Blue Shield of California EPN |
$1.53
|
| Rate for Payer: Cash Price |
$1.37
|
| Rate for Payer: Central Health Plan Commercial |
$2.43
|
| Rate for Payer: Cigna of CA HMO |
$2.13
|
| Rate for Payer: Cigna of CA PPO |
$2.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.22
|
| Rate for Payer: EPIC Health Plan Senior |
$1.22
|
| Rate for Payer: Galaxy Health WC |
$2.58
|
| Rate for Payer: Global Benefits Group Commercial |
$1.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.74
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.61
|
| Rate for Payer: Multiplan Commercial |
$2.28
|
| Rate for Payer: Networks By Design Commercial |
$1.52
|
| Rate for Payer: Prime Health Services Commercial |
$2.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.14
|
| Rate for Payer: United Healthcare All Other HMO |
$1.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.00
|
|
|
MEPERIDINE (PF) 25 MG/ML INJECTION SOLUTION [117787]
|
Facility
|
OP
|
$3.04
|
|
|
Service Code
|
HCPCS J2175
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$62.83 |
| Rate for Payer: Adventist Health Commercial |
$0.61
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$8.06
|
| Rate for Payer: Blue Shield of California EPN |
$7.33
|
| Rate for Payer: Cash Price |
$1.37
|
| Rate for Payer: Cash Price |
$1.37
|
| Rate for Payer: Central Health Plan Commercial |
$2.43
|
| Rate for Payer: Cigna of CA HMO |
$2.13
|
| Rate for Payer: Cigna of CA PPO |
$2.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.22
|
| Rate for Payer: EPIC Health Plan Senior |
$1.22
|
| Rate for Payer: Galaxy Health WC |
$2.58
|
| Rate for Payer: Global Benefits Group Commercial |
$1.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.13
|
| Rate for Payer: Multiplan Commercial |
$2.28
|
| Rate for Payer: Networks By Design Commercial |
$1.52
|
| Rate for Payer: Prime Health Services Commercial |
$2.58
|
| Rate for Payer: Riverside University Health System MISP |
$1.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.14
|
| Rate for Payer: United Healthcare All Other HMO |
$1.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.58
|
| Rate for Payer: Vantage Medical Group Senior |
$2.58
|
|
|
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION [4904]
|
Facility
|
IP
|
$3.17
|
|
|
Service Code
|
HCPCS J2175
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$2.85 |
| Rate for Payer: Adventist Health Commercial |
$0.63
|
| Rate for Payer: Blue Shield of California Commercial |
$2.54
|
| Rate for Payer: Blue Shield of California EPN |
$1.60
|
| Rate for Payer: Cash Price |
$1.43
|
| Rate for Payer: Central Health Plan Commercial |
$2.54
|
| Rate for Payer: Cigna of CA HMO |
$2.22
|
| Rate for Payer: Cigna of CA PPO |
$2.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.27
|
| Rate for Payer: EPIC Health Plan Senior |
$1.27
|
| Rate for Payer: Galaxy Health WC |
$2.69
|
| Rate for Payer: Global Benefits Group Commercial |
$1.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.63
|
| Rate for Payer: Multiplan Commercial |
$2.38
|
| Rate for Payer: Networks By Design Commercial |
$1.58
|
| Rate for Payer: Prime Health Services Commercial |
$2.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.19
|
| Rate for Payer: United Healthcare All Other HMO |
$1.16
|
| Rate for Payer: United Healthcare HMO Rider |
$1.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.04
|
|
|
MEPERIDINE (PF) 50 MG/ML INJECTION SOLUTION [4904]
|
Facility
|
OP
|
$3.17
|
|
|
Service Code
|
HCPCS J2175
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.63 |
| Max. Negotiated Rate |
$62.83 |
| Rate for Payer: Adventist Health Commercial |
$0.63
|
| Rate for Payer: Aetna of CA HMO/PPO |
$62.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$8.06
|
| Rate for Payer: Blue Shield of California EPN |
$7.33
|
| Rate for Payer: Cash Price |
$1.43
|
| Rate for Payer: Cash Price |
$1.43
|
| Rate for Payer: Central Health Plan Commercial |
$2.54
|
| Rate for Payer: Cigna of CA HMO |
$2.22
|
| Rate for Payer: Cigna of CA PPO |
$2.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.27
|
| Rate for Payer: EPIC Health Plan Senior |
$1.27
|
| Rate for Payer: Galaxy Health WC |
$2.69
|
| Rate for Payer: Global Benefits Group Commercial |
$1.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.63
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.22
|
| Rate for Payer: Multiplan Commercial |
$2.38
|
| Rate for Payer: Networks By Design Commercial |
$1.58
|
| Rate for Payer: Prime Health Services Commercial |
$2.69
|
| Rate for Payer: Riverside University Health System MISP |
$1.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.90
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.19
|
| Rate for Payer: United Healthcare All Other HMO |
$1.16
|
| Rate for Payer: United Healthcare HMO Rider |
$1.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2.69
|
|
|
MEPIVACAINE (PF) 15 MG/ML (1.5 %) INJECTION SOLUTION [10529]
|
Facility
|
IP
|
$0.69
|
|
|
Service Code
|
HCPCS J0670
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$0.62 |
| Rate for Payer: Adventist Health Commercial |
$0.14
|
| Rate for Payer: Blue Shield of California Commercial |
$0.55
|
| Rate for Payer: Blue Shield of California EPN |
$0.35
|
| Rate for Payer: Cash Price |
$0.31
|
| Rate for Payer: Central Health Plan Commercial |
$0.55
|
| Rate for Payer: Cigna of CA HMO |
$0.48
|
| Rate for Payer: Cigna of CA PPO |
$0.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: EPIC Health Plan Senior |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.59
|
| Rate for Payer: Global Benefits Group Commercial |
$0.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
| Rate for Payer: Multiplan Commercial |
$0.52
|
| Rate for Payer: Networks By Design Commercial |
$0.35
|
| Rate for Payer: Prime Health Services Commercial |
$0.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.26
|
| Rate for Payer: United Healthcare All Other HMO |
$0.25
|
| Rate for Payer: United Healthcare HMO Rider |
$0.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.23
|
|
|
MEPIVACAINE (PF) 15 MG/ML (1.5 %) INJECTION SOLUTION [10529]
|
Facility
|
OP
|
$0.69
|
|
|
Service Code
|
HCPCS J0670
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$34.42 |
| Rate for Payer: Adventist Health Commercial |
$0.14
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.42
|
| Rate for Payer: Blue Shield of California Commercial |
$3.62
|
| Rate for Payer: Blue Shield of California EPN |
$3.29
|
| Rate for Payer: Cash Price |
$0.31
|
| Rate for Payer: Cash Price |
$0.31
|
| Rate for Payer: Central Health Plan Commercial |
$0.55
|
| Rate for Payer: Cigna of CA HMO |
$0.48
|
| Rate for Payer: Cigna of CA PPO |
$0.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.59
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: EPIC Health Plan Senior |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.59
|
| Rate for Payer: Global Benefits Group Commercial |
$0.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.48
|
| Rate for Payer: Multiplan Commercial |
$0.52
|
| Rate for Payer: Networks By Design Commercial |
$0.35
|
| Rate for Payer: Prime Health Services Commercial |
$0.59
|
| Rate for Payer: Riverside University Health System MISP |
$0.28
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.26
|
| Rate for Payer: United Healthcare All Other HMO |
$0.25
|
| Rate for Payer: United Healthcare HMO Rider |
$0.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Vantage Medical Group Senior |
$0.59
|
|
|
MEPIVACAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION [105638]
|
Facility
|
OP
|
$0.84
|
|
|
Service Code
|
HCPCS J0670
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$34.42 |
| Rate for Payer: Adventist Health Commercial |
$0.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.71
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.42
|
| Rate for Payer: Blue Shield of California Commercial |
$3.62
|
| Rate for Payer: Blue Shield of California EPN |
$3.29
|
| Rate for Payer: Cash Price |
$0.38
|
| Rate for Payer: Cash Price |
$0.38
|
| Rate for Payer: Central Health Plan Commercial |
$0.67
|
| Rate for Payer: Cigna of CA HMO |
$0.59
|
| Rate for Payer: Cigna of CA PPO |
$0.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.71
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.71
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.34
|
| Rate for Payer: EPIC Health Plan Senior |
$0.34
|
| Rate for Payer: Galaxy Health WC |
$0.71
|
| Rate for Payer: Global Benefits Group Commercial |
$0.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.59
|
| Rate for Payer: Multiplan Commercial |
$0.63
|
| Rate for Payer: Networks By Design Commercial |
$0.42
|
| Rate for Payer: Prime Health Services Commercial |
$0.71
|
| Rate for Payer: Riverside University Health System MISP |
$0.34
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.32
|
| Rate for Payer: United Healthcare All Other HMO |
$0.31
|
| Rate for Payer: United Healthcare HMO Rider |
$0.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.71
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.71
|
| Rate for Payer: Vantage Medical Group Senior |
$0.71
|
|
|
MEPIVACAINE (PF) 20 MG/ML (2 %) INJECTION SOLUTION [105638]
|
Facility
|
IP
|
$0.84
|
|
|
Service Code
|
HCPCS J0670
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.17 |
| Max. Negotiated Rate |
$0.76 |
| Rate for Payer: Adventist Health Commercial |
$0.17
|
| Rate for Payer: Blue Shield of California Commercial |
$0.67
|
| Rate for Payer: Blue Shield of California EPN |
$0.42
|
| Rate for Payer: Cash Price |
$0.38
|
| Rate for Payer: Central Health Plan Commercial |
$0.67
|
| Rate for Payer: Cigna of CA HMO |
$0.59
|
| Rate for Payer: Cigna of CA PPO |
$0.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.34
|
| Rate for Payer: EPIC Health Plan Senior |
$0.34
|
| Rate for Payer: Galaxy Health WC |
$0.71
|
| Rate for Payer: Global Benefits Group Commercial |
$0.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.76
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.63
|
| Rate for Payer: Networks By Design Commercial |
$0.42
|
| Rate for Payer: Prime Health Services Commercial |
$0.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.32
|
| Rate for Payer: United Healthcare All Other HMO |
$0.31
|
| Rate for Payer: United Healthcare HMO Rider |
$0.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.28
|
|
|
MEPIVACAINE (PF) 30 MG/ML (3 %) INJECTION SOLUTION [4081086]
|
Facility
|
OP
|
$1.27
|
|
|
Service Code
|
HCPCS J0670
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.25 |
| Max. Negotiated Rate |
$34.42 |
| Rate for Payer: Adventist Health Commercial |
$0.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$22.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$27.58
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$34.42
|
| Rate for Payer: Blue Shield of California Commercial |
$3.62
|
| Rate for Payer: Blue Shield of California EPN |
$3.29
|
| Rate for Payer: Cash Price |
$0.57
|
| Rate for Payer: Cash Price |
$0.57
|
| Rate for Payer: Central Health Plan Commercial |
$1.02
|
| Rate for Payer: Cigna of CA HMO |
$0.89
|
| Rate for Payer: Cigna of CA PPO |
$0.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.08
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.51
|
| Rate for Payer: EPIC Health Plan Senior |
$0.51
|
| Rate for Payer: Galaxy Health WC |
$1.08
|
| Rate for Payer: Global Benefits Group Commercial |
$0.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.75
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.89
|
| Rate for Payer: Multiplan Commercial |
$0.95
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$1.08
|
| Rate for Payer: Riverside University Health System MISP |
$0.51
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.48
|
| Rate for Payer: United Healthcare All Other HMO |
$0.46
|
| Rate for Payer: United Healthcare HMO Rider |
$0.45
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.42
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.08
|
| Rate for Payer: Vantage Medical Group Senior |
$1.08
|
|
