|
METHYLERGONOVINE 0.2 MG TABLET [10572]
|
Facility
|
OP
|
$19.80
|
|
|
Service Code
|
NDC 6923816052
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.96 |
| Max. Negotiated Rate |
$17.82 |
| Rate for Payer: Adventist Health Commercial |
$3.96
|
| Rate for Payer: Aetna of CA HMO/PPO |
$12.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$16.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$14.85
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.59
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$11.52
|
| Rate for Payer: Blue Shield of California Commercial |
$12.55
|
| Rate for Payer: Blue Shield of California EPN |
$7.90
|
| Rate for Payer: Cash Price |
$8.91
|
| Rate for Payer: Central Health Plan Commercial |
$15.84
|
| Rate for Payer: Cigna of CA HMO |
$13.86
|
| Rate for Payer: Cigna of CA PPO |
$13.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.92
|
| Rate for Payer: EPIC Health Plan Senior |
$7.92
|
| Rate for Payer: Galaxy Health WC |
$16.83
|
| Rate for Payer: Global Benefits Group Commercial |
$11.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13.86
|
| Rate for Payer: Multiplan Commercial |
$14.85
|
| Rate for Payer: Networks By Design Commercial |
$12.87
|
| Rate for Payer: Prime Health Services Commercial |
$16.83
|
| Rate for Payer: Riverside University Health System MISP |
$7.92
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$11.88
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$11.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.90
|
| Rate for Payer: United Healthcare All Other HMO |
$9.90
|
| Rate for Payer: United Healthcare HMO Rider |
$9.90
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$16.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.83
|
| Rate for Payer: Vantage Medical Group Senior |
$16.83
|
|
|
METHYLERGONOVINE 0.2 MG TABLET [10572]
|
Facility
|
IP
|
$19.80
|
|
|
Service Code
|
NDC 6923816058
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.96 |
| Max. Negotiated Rate |
$17.82 |
| Rate for Payer: Adventist Health Commercial |
$3.96
|
| Rate for Payer: Blue Shield of California Commercial |
$15.88
|
| Rate for Payer: Blue Shield of California EPN |
$9.98
|
| Rate for Payer: Cash Price |
$8.91
|
| Rate for Payer: Central Health Plan Commercial |
$15.84
|
| Rate for Payer: Cigna of CA HMO |
$13.86
|
| Rate for Payer: Cigna of CA PPO |
$13.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$13.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.92
|
| Rate for Payer: EPIC Health Plan Senior |
$7.92
|
| Rate for Payer: Galaxy Health WC |
$16.83
|
| Rate for Payer: Global Benefits Group Commercial |
$11.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$17.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$12.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.96
|
| Rate for Payer: Multiplan Commercial |
$14.85
|
| Rate for Payer: Networks By Design Commercial |
$12.87
|
| Rate for Payer: Prime Health Services Commercial |
$16.83
|
|
|
METHYLERGONOVINE 0.2 MG TABLET [10572]
|
Facility
|
IP
|
$16.83
|
|
|
Service Code
|
NDC 7001078612
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.37 |
| Max. Negotiated Rate |
$15.15 |
| Rate for Payer: Adventist Health Commercial |
$3.37
|
| Rate for Payer: Blue Shield of California Commercial |
$13.50
|
| Rate for Payer: Blue Shield of California EPN |
$8.48
|
| Rate for Payer: Cash Price |
$7.57
|
| Rate for Payer: Central Health Plan Commercial |
$13.46
|
| Rate for Payer: Cigna of CA HMO |
$11.78
|
| Rate for Payer: Cigna of CA PPO |
$11.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.73
|
| Rate for Payer: EPIC Health Plan Senior |
$6.73
|
| Rate for Payer: Galaxy Health WC |
$14.31
|
| Rate for Payer: Global Benefits Group Commercial |
$10.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.37
|
| Rate for Payer: Multiplan Commercial |
$12.62
|
| Rate for Payer: Networks By Design Commercial |
$10.94
|
| Rate for Payer: Prime Health Services Commercial |
$14.31
|
|
|
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SYRINGE [154475]
|
Facility
|
IP
|
$373.50
|
|
|
Service Code
|
HCPCS J2212
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.70 |
| Max. Negotiated Rate |
$336.15 |
| Rate for Payer: Adventist Health Commercial |
$74.70
|
| Rate for Payer: Blue Shield of California Commercial |
$299.55
|
| Rate for Payer: Blue Shield of California EPN |
$188.24
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Central Health Plan Commercial |
$298.80
|
| Rate for Payer: Cigna of CA HMO |
$261.45
|
| Rate for Payer: Cigna of CA PPO |
$261.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.40
|
| Rate for Payer: EPIC Health Plan Senior |
$149.40
|
| Rate for Payer: Galaxy Health WC |
$317.48
|
| Rate for Payer: Global Benefits Group Commercial |
$224.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.70
|
| Rate for Payer: Multiplan Commercial |
$280.12
|
| Rate for Payer: Networks By Design Commercial |
$186.75
|
| Rate for Payer: Prime Health Services Commercial |
$317.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$140.17
|
| Rate for Payer: United Healthcare All Other HMO |
$136.44
|
| Rate for Payer: United Healthcare HMO Rider |
$133.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$122.32
|
|
|
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS SYRINGE [154475]
|
Facility
|
OP
|
$373.50
|
|
|
Service Code
|
HCPCS J2212
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$336.15 |
| Rate for Payer: Adventist Health Commercial |
$74.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$317.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$205.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$280.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.96
|
| Rate for Payer: Blue Shield of California Commercial |
$1.76
|
| Rate for Payer: Blue Shield of California EPN |
$1.60
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Central Health Plan Commercial |
$298.80
|
| Rate for Payer: Cigna of CA HMO |
$261.45
|
| Rate for Payer: Cigna of CA PPO |
$261.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$317.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$317.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.40
|
| Rate for Payer: EPIC Health Plan Senior |
$149.40
|
| Rate for Payer: Galaxy Health WC |
$317.48
|
| Rate for Payer: Global Benefits Group Commercial |
$224.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$135.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$261.45
|
| Rate for Payer: Multiplan Commercial |
$280.12
|
| Rate for Payer: Networks By Design Commercial |
$186.75
|
| Rate for Payer: Prime Health Services Commercial |
$317.48
|
| Rate for Payer: Riverside University Health System MISP |
$149.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$140.17
|
| Rate for Payer: United Healthcare All Other HMO |
$136.44
|
| Rate for Payer: United Healthcare HMO Rider |
$133.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$122.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$317.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$317.48
|
| Rate for Payer: Vantage Medical Group Senior |
$317.48
|
|
|
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS WRAP [40891651]
|
Facility
|
IP
|
$373.50
|
|
|
Service Code
|
HCPCS J2212
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$74.70 |
| Max. Negotiated Rate |
$336.15 |
| Rate for Payer: Adventist Health Commercial |
$74.70
|
| Rate for Payer: Blue Shield of California Commercial |
$299.55
|
| Rate for Payer: Blue Shield of California EPN |
$188.24
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Central Health Plan Commercial |
$298.80
|
| Rate for Payer: Cigna of CA HMO |
$261.45
|
| Rate for Payer: Cigna of CA PPO |
$261.45
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.40
|
| Rate for Payer: EPIC Health Plan Senior |
$149.40
|
| Rate for Payer: Galaxy Health WC |
$317.48
|
| Rate for Payer: Global Benefits Group Commercial |
$224.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.70
|
| Rate for Payer: Multiplan Commercial |
$280.12
|
| Rate for Payer: Networks By Design Commercial |
$186.75
|
| Rate for Payer: Prime Health Services Commercial |
$317.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$140.17
|
| Rate for Payer: United Healthcare All Other HMO |
$136.44
|
| Rate for Payer: United Healthcare HMO Rider |
$133.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$122.32
|
|
|
METHYLNALTREXONE 12 MG/0.6 ML SUBCUTANEOUS WRAP [40891651]
|
Facility
|
OP
|
$373.50
|
|
|
Service Code
|
HCPCS J2212
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$336.15 |
| Rate for Payer: Adventist Health Commercial |
$74.70
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.65
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$317.48
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$205.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$280.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.96
|
| Rate for Payer: Blue Shield of California Commercial |
$1.76
|
| Rate for Payer: Blue Shield of California EPN |
$1.60
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Cash Price |
$168.08
|
| Rate for Payer: Central Health Plan Commercial |
$298.80
|
| Rate for Payer: Cigna of CA HMO |
$261.45
|
| Rate for Payer: Cigna of CA PPO |
$261.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$317.48
|
| Rate for Payer: Dignity Health Medi-Cal |
$317.48
|
| Rate for Payer: Dignity Health Medicare Advantage |
$317.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$261.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$149.40
|
| Rate for Payer: EPIC Health Plan Senior |
$149.40
|
| Rate for Payer: Galaxy Health WC |
$317.48
|
| Rate for Payer: Global Benefits Group Commercial |
$224.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$336.15
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$237.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$135.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$220.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$74.70
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$261.45
|
| Rate for Payer: Multiplan Commercial |
$280.12
|
| Rate for Payer: Networks By Design Commercial |
$186.75
|
| Rate for Payer: Prime Health Services Commercial |
$317.48
|
| Rate for Payer: Riverside University Health System MISP |
$149.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$224.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$224.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$140.17
|
| Rate for Payer: United Healthcare All Other HMO |
$136.44
|
| Rate for Payer: United Healthcare HMO Rider |
$133.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$122.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$317.48
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$317.48
|
| Rate for Payer: Vantage Medical Group Senior |
$317.48
|
|
|
METHYLPHENIDATE 5 MG TABLET [4988]
|
Facility
|
IP
|
$2.81
|
|
|
Service Code
|
NDC 6808480521
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.56 |
| Max. Negotiated Rate |
$2.53 |
| Rate for Payer: Adventist Health Commercial |
$0.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.25
|
| Rate for Payer: Blue Shield of California EPN |
$1.42
|
| Rate for Payer: Cash Price |
$1.26
|
| Rate for Payer: Central Health Plan Commercial |
$2.25
|
| Rate for Payer: Cigna of CA HMO |
$1.97
|
| Rate for Payer: Cigna of CA PPO |
$1.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.12
|
| Rate for Payer: EPIC Health Plan Senior |
$1.12
|
| Rate for Payer: Galaxy Health WC |
$2.39
|
| Rate for Payer: Global Benefits Group Commercial |
$1.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.56
|
| Rate for Payer: Multiplan Commercial |
$2.11
|
| Rate for Payer: Networks By Design Commercial |
$1.83
|
| Rate for Payer: Prime Health Services Commercial |
$2.39
|
|
|
METHYLPHENIDATE 5 MG TABLET [4988]
|
Facility
|
OP
|
$2.81
|
|
|
Service Code
|
NDC 6808480521
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.56 |
| Max. Negotiated Rate |
$2.53 |
| Rate for Payer: Adventist Health Commercial |
$0.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.63
|
| Rate for Payer: Blue Shield of California Commercial |
$1.78
|
| Rate for Payer: Blue Shield of California EPN |
$1.12
|
| Rate for Payer: Cash Price |
$1.26
|
| Rate for Payer: Central Health Plan Commercial |
$2.25
|
| Rate for Payer: Cigna of CA HMO |
$1.97
|
| Rate for Payer: Cigna of CA PPO |
$1.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.39
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.39
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.12
|
| Rate for Payer: EPIC Health Plan Senior |
$1.12
|
| Rate for Payer: Galaxy Health WC |
$2.39
|
| Rate for Payer: Global Benefits Group Commercial |
$1.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.97
|
| Rate for Payer: Multiplan Commercial |
$2.11
|
| Rate for Payer: Networks By Design Commercial |
$1.83
|
| Rate for Payer: Prime Health Services Commercial |
$2.39
|
| Rate for Payer: Riverside University Health System MISP |
$1.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.41
|
| Rate for Payer: United Healthcare All Other HMO |
$1.41
|
| Rate for Payer: United Healthcare HMO Rider |
$1.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.39
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.39
|
| Rate for Payer: Vantage Medical Group Senior |
$2.39
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR [28750]
|
Facility
|
OP
|
$15.48
|
|
|
Service Code
|
NDC 5045858501
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$13.93 |
| Rate for Payer: Adventist Health Commercial |
$3.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.16
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.50
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.00
|
| Rate for Payer: Blue Shield of California Commercial |
$9.81
|
| Rate for Payer: Blue Shield of California EPN |
$6.18
|
| Rate for Payer: Cash Price |
$6.97
|
| Rate for Payer: Central Health Plan Commercial |
$12.38
|
| Rate for Payer: Cigna of CA HMO |
$10.84
|
| Rate for Payer: Cigna of CA PPO |
$10.84
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.19
|
| Rate for Payer: EPIC Health Plan Senior |
$6.19
|
| Rate for Payer: Galaxy Health WC |
$13.16
|
| Rate for Payer: Global Benefits Group Commercial |
$9.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10.84
|
| Rate for Payer: Multiplan Commercial |
$11.61
|
| Rate for Payer: Networks By Design Commercial |
$10.06
|
| Rate for Payer: Prime Health Services Commercial |
$13.16
|
| Rate for Payer: Riverside University Health System MISP |
$6.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.74
|
| Rate for Payer: United Healthcare All Other HMO |
$7.74
|
| Rate for Payer: United Healthcare HMO Rider |
$7.74
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.74
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.16
|
| Rate for Payer: Vantage Medical Group Senior |
$13.16
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR [28750]
|
Facility
|
IP
|
$6.22
|
|
|
Service Code
|
NDC 6217531037
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$5.60 |
| Rate for Payer: Adventist Health Commercial |
$1.24
|
| Rate for Payer: Blue Shield of California Commercial |
$4.99
|
| Rate for Payer: Blue Shield of California EPN |
$3.13
|
| Rate for Payer: Cash Price |
$2.80
|
| Rate for Payer: Central Health Plan Commercial |
$4.98
|
| Rate for Payer: Cigna of CA HMO |
$4.35
|
| Rate for Payer: Cigna of CA PPO |
$4.35
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.49
|
| Rate for Payer: EPIC Health Plan Senior |
$2.49
|
| Rate for Payer: Galaxy Health WC |
$5.29
|
| Rate for Payer: Global Benefits Group Commercial |
$3.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.24
|
| Rate for Payer: Multiplan Commercial |
$4.67
|
| Rate for Payer: Networks By Design Commercial |
$4.04
|
| Rate for Payer: Prime Health Services Commercial |
$5.29
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR [28750]
|
Facility
|
OP
|
$6.22
|
|
|
Service Code
|
NDC 6217531037
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.24 |
| Max. Negotiated Rate |
$5.60 |
| Rate for Payer: Adventist Health Commercial |
$1.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.62
|
| Rate for Payer: Blue Shield of California Commercial |
$3.94
|
| Rate for Payer: Blue Shield of California EPN |
$2.48
|
| Rate for Payer: Cash Price |
$2.80
|
| Rate for Payer: Central Health Plan Commercial |
$4.98
|
| Rate for Payer: Cigna of CA HMO |
$4.35
|
| Rate for Payer: Cigna of CA PPO |
$4.35
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.49
|
| Rate for Payer: EPIC Health Plan Senior |
$2.49
|
| Rate for Payer: Galaxy Health WC |
$5.29
|
| Rate for Payer: Global Benefits Group Commercial |
$3.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4.35
|
| Rate for Payer: Multiplan Commercial |
$4.67
|
| Rate for Payer: Networks By Design Commercial |
$4.04
|
| Rate for Payer: Prime Health Services Commercial |
$5.29
|
| Rate for Payer: Riverside University Health System MISP |
$2.49
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.73
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.11
|
| Rate for Payer: United Healthcare All Other HMO |
$3.11
|
| Rate for Payer: United Healthcare HMO Rider |
$3.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.29
|
| Rate for Payer: Vantage Medical Group Senior |
$5.29
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR [28750]
|
Facility
|
IP
|
$15.48
|
|
|
Service Code
|
NDC 5045858501
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.10 |
| Max. Negotiated Rate |
$13.93 |
| Rate for Payer: Adventist Health Commercial |
$3.10
|
| Rate for Payer: Blue Shield of California Commercial |
$12.41
|
| Rate for Payer: Blue Shield of California EPN |
$7.80
|
| Rate for Payer: Cash Price |
$6.97
|
| Rate for Payer: Central Health Plan Commercial |
$12.38
|
| Rate for Payer: Cigna of CA HMO |
$10.84
|
| Rate for Payer: Cigna of CA PPO |
$10.84
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$10.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.19
|
| Rate for Payer: EPIC Health Plan Senior |
$6.19
|
| Rate for Payer: Galaxy Health WC |
$13.16
|
| Rate for Payer: Global Benefits Group Commercial |
$9.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$9.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.10
|
| Rate for Payer: Multiplan Commercial |
$11.61
|
| Rate for Payer: Networks By Design Commercial |
$10.06
|
| Rate for Payer: Prime Health Services Commercial |
$13.16
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR [28750]
|
Facility
|
OP
|
$9.34
|
|
|
Service Code
|
NDC 9999706851
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$8.41 |
| Rate for Payer: Adventist Health Commercial |
$1.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.43
|
| Rate for Payer: Blue Shield of California Commercial |
$5.92
|
| Rate for Payer: Blue Shield of California EPN |
$3.73
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Central Health Plan Commercial |
$7.47
|
| Rate for Payer: Cigna of CA HMO |
$6.54
|
| Rate for Payer: Cigna of CA PPO |
$6.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.94
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.74
|
| Rate for Payer: EPIC Health Plan Senior |
$3.74
|
| Rate for Payer: Galaxy Health WC |
$7.94
|
| Rate for Payer: Global Benefits Group Commercial |
$5.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.54
|
| Rate for Payer: Multiplan Commercial |
$7.00
|
| Rate for Payer: Networks By Design Commercial |
$6.07
|
| Rate for Payer: Prime Health Services Commercial |
$7.94
|
| Rate for Payer: Riverside University Health System MISP |
$3.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.67
|
| Rate for Payer: United Healthcare All Other HMO |
$4.67
|
| Rate for Payer: United Healthcare HMO Rider |
$4.67
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.94
|
| Rate for Payer: Vantage Medical Group Senior |
$7.94
|
|
|
METHYLPHENIDATE ER 18 MG TABLET,EXTENDED RELEASE 24 HR [28750]
|
Facility
|
IP
|
$9.34
|
|
|
Service Code
|
NDC 9999706851
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.87 |
| Max. Negotiated Rate |
$8.41 |
| Rate for Payer: Adventist Health Commercial |
$1.87
|
| Rate for Payer: Blue Shield of California Commercial |
$7.49
|
| Rate for Payer: Blue Shield of California EPN |
$4.71
|
| Rate for Payer: Cash Price |
$4.20
|
| Rate for Payer: Central Health Plan Commercial |
$7.47
|
| Rate for Payer: Cigna of CA HMO |
$6.54
|
| Rate for Payer: Cigna of CA PPO |
$6.54
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.74
|
| Rate for Payer: EPIC Health Plan Senior |
$3.74
|
| Rate for Payer: Galaxy Health WC |
$7.94
|
| Rate for Payer: Global Benefits Group Commercial |
$5.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.93
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.87
|
| Rate for Payer: Multiplan Commercial |
$7.00
|
| Rate for Payer: Networks By Design Commercial |
$6.07
|
| Rate for Payer: Prime Health Services Commercial |
$7.94
|
|
|
METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE [4989]
|
Facility
|
OP
|
$2.02
|
|
|
Service Code
|
NDC 1070207606
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$1.82 |
| Rate for Payer: Adventist Health Commercial |
$0.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.72
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.18
|
| Rate for Payer: Blue Shield of California Commercial |
$1.28
|
| Rate for Payer: Blue Shield of California EPN |
$0.81
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Central Health Plan Commercial |
$1.62
|
| Rate for Payer: Cigna of CA HMO |
$1.41
|
| Rate for Payer: Cigna of CA PPO |
$1.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.72
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.72
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.81
|
| Rate for Payer: EPIC Health Plan Senior |
$0.81
|
| Rate for Payer: Galaxy Health WC |
$1.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.41
|
| Rate for Payer: Multiplan Commercial |
$1.51
|
| Rate for Payer: Networks By Design Commercial |
$1.31
|
| Rate for Payer: Prime Health Services Commercial |
$1.72
|
| Rate for Payer: Riverside University Health System MISP |
$0.81
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.01
|
| Rate for Payer: United Healthcare All Other HMO |
$1.01
|
| Rate for Payer: United Healthcare HMO Rider |
$1.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.72
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.72
|
| Rate for Payer: Vantage Medical Group Senior |
$1.72
|
|
|
METHYLPHENIDATE ER 20 MG TABLET,EXTENDED RELEASE [4989]
|
Facility
|
IP
|
$2.02
|
|
|
Service Code
|
NDC 1070207606
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.40 |
| Max. Negotiated Rate |
$1.82 |
| Rate for Payer: Adventist Health Commercial |
$0.40
|
| Rate for Payer: Blue Shield of California Commercial |
$1.62
|
| Rate for Payer: Blue Shield of California EPN |
$1.02
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Central Health Plan Commercial |
$1.62
|
| Rate for Payer: Cigna of CA HMO |
$1.41
|
| Rate for Payer: Cigna of CA PPO |
$1.41
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.81
|
| Rate for Payer: EPIC Health Plan Senior |
$0.81
|
| Rate for Payer: Galaxy Health WC |
$1.72
|
| Rate for Payer: Global Benefits Group Commercial |
$1.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.82
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.40
|
| Rate for Payer: Multiplan Commercial |
$1.51
|
| Rate for Payer: Networks By Design Commercial |
$1.31
|
| Rate for Payer: Prime Health Services Commercial |
$1.72
|
|
|
METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR [32654]
|
Facility
|
IP
|
$15.87
|
|
|
Service Code
|
NDC 5045858801
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$14.28 |
| Rate for Payer: Adventist Health Commercial |
$3.17
|
| Rate for Payer: Blue Shield of California Commercial |
$12.73
|
| Rate for Payer: Blue Shield of California EPN |
$8.00
|
| Rate for Payer: Cash Price |
$7.14
|
| Rate for Payer: Central Health Plan Commercial |
$12.70
|
| Rate for Payer: Cigna of CA HMO |
$11.11
|
| Rate for Payer: Cigna of CA PPO |
$11.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.35
|
| Rate for Payer: EPIC Health Plan Senior |
$6.35
|
| Rate for Payer: Galaxy Health WC |
$13.49
|
| Rate for Payer: Global Benefits Group Commercial |
$9.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.17
|
| Rate for Payer: Multiplan Commercial |
$11.90
|
| Rate for Payer: Networks By Design Commercial |
$10.32
|
| Rate for Payer: Prime Health Services Commercial |
$13.49
|
|
|
METHYLPHENIDATE ER 27 MG TABLET,EXTENDED RELEASE 24 HR [32654]
|
Facility
|
OP
|
$15.87
|
|
|
Service Code
|
NDC 5045858801
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$14.28 |
| Rate for Payer: Adventist Health Commercial |
$3.17
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.73
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$11.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.68
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.23
|
| Rate for Payer: Blue Shield of California Commercial |
$10.06
|
| Rate for Payer: Blue Shield of California EPN |
$6.33
|
| Rate for Payer: Cash Price |
$7.14
|
| Rate for Payer: Central Health Plan Commercial |
$12.70
|
| Rate for Payer: Cigna of CA HMO |
$11.11
|
| Rate for Payer: Cigna of CA PPO |
$11.11
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.49
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.49
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.35
|
| Rate for Payer: EPIC Health Plan Senior |
$6.35
|
| Rate for Payer: Galaxy Health WC |
$13.49
|
| Rate for Payer: Global Benefits Group Commercial |
$9.52
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.28
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.11
|
| Rate for Payer: Multiplan Commercial |
$11.90
|
| Rate for Payer: Networks By Design Commercial |
$10.32
|
| Rate for Payer: Prime Health Services Commercial |
$13.49
|
| Rate for Payer: Riverside University Health System MISP |
$6.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.52
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.93
|
| Rate for Payer: United Healthcare All Other HMO |
$7.93
|
| Rate for Payer: United Healthcare HMO Rider |
$7.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.49
|
| Rate for Payer: Vantage Medical Group Senior |
$13.49
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]
|
Facility
|
OP
|
$16.37
|
|
|
Service Code
|
NDC 5045858601
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$14.73 |
| Rate for Payer: Adventist Health Commercial |
$3.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$9.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.28
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.52
|
| Rate for Payer: Blue Shield of California Commercial |
$10.38
|
| Rate for Payer: Blue Shield of California EPN |
$6.53
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Central Health Plan Commercial |
$13.10
|
| Rate for Payer: Cigna of CA HMO |
$11.46
|
| Rate for Payer: Cigna of CA PPO |
$11.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.91
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.91
|
| Rate for Payer: Dignity Health Medicare Advantage |
$13.91
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.55
|
| Rate for Payer: EPIC Health Plan Senior |
$6.55
|
| Rate for Payer: Galaxy Health WC |
$13.91
|
| Rate for Payer: Global Benefits Group Commercial |
$9.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11.46
|
| Rate for Payer: Multiplan Commercial |
$12.28
|
| Rate for Payer: Networks By Design Commercial |
$10.64
|
| Rate for Payer: Prime Health Services Commercial |
$13.91
|
| Rate for Payer: Riverside University Health System MISP |
$6.55
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.19
|
| Rate for Payer: United Healthcare All Other HMO |
$8.19
|
| Rate for Payer: United Healthcare HMO Rider |
$8.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$13.91
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.91
|
| Rate for Payer: Vantage Medical Group Senior |
$13.91
|
|
|
METHYLPHENIDATE ER 36 MG TABLET,EXTENDED RELEASE 24 HR [28751]
|
Facility
|
IP
|
$16.37
|
|
|
Service Code
|
NDC 5045858601
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.27 |
| Max. Negotiated Rate |
$14.73 |
| Rate for Payer: Adventist Health Commercial |
$3.27
|
| Rate for Payer: Blue Shield of California Commercial |
$13.13
|
| Rate for Payer: Blue Shield of California EPN |
$8.25
|
| Rate for Payer: Cash Price |
$7.37
|
| Rate for Payer: Central Health Plan Commercial |
$13.10
|
| Rate for Payer: Cigna of CA HMO |
$11.46
|
| Rate for Payer: Cigna of CA PPO |
$11.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$11.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.55
|
| Rate for Payer: EPIC Health Plan Senior |
$6.55
|
| Rate for Payer: Galaxy Health WC |
$13.91
|
| Rate for Payer: Global Benefits Group Commercial |
$9.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$10.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.27
|
| Rate for Payer: Multiplan Commercial |
$12.28
|
| Rate for Payer: Networks By Design Commercial |
$10.64
|
| Rate for Payer: Prime Health Services Commercial |
$13.91
|
|
|
METHYLPREDNISOLONE 125 MG INJ. [4081205]
|
Facility
|
OP
|
$9.12
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$8.97 |
| Rate for Payer: Adventist Health Commercial |
$1.82
|
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Adventist Health Commercial |
$2.50
|
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.53
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.69
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.84
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.48
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.48
|
| Rate for Payer: Blue Shield of California Commercial |
$0.29
|
| Rate for Payer: Blue Shield of California Commercial |
$0.29
|
| Rate for Payer: Blue Shield of California Commercial |
$0.29
|
| Rate for Payer: Blue Shield of California Commercial |
$0.29
|
| Rate for Payer: Blue Shield of California EPN |
$0.26
|
| Rate for Payer: Blue Shield of California EPN |
$0.26
|
| Rate for Payer: Blue Shield of California EPN |
$0.26
|
| Rate for Payer: Blue Shield of California EPN |
$0.26
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$10.00
|
| Rate for Payer: Central Health Plan Commercial |
$7.30
|
| Rate for Payer: Central Health Plan Commercial |
$3.07
|
| Rate for Payer: Central Health Plan Commercial |
$11.18
|
| Rate for Payer: Cigna of CA HMO |
$9.79
|
| Rate for Payer: Cigna of CA HMO |
$2.69
|
| Rate for Payer: Cigna of CA HMO |
$6.38
|
| Rate for Payer: Cigna of CA HMO |
$8.75
|
| Rate for Payer: Cigna of CA PPO |
$2.69
|
| Rate for Payer: Cigna of CA PPO |
$6.38
|
| Rate for Payer: Cigna of CA PPO |
$8.75
|
| Rate for Payer: Cigna of CA PPO |
$9.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.62
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$5.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5.59
|
| Rate for Payer: EPIC Health Plan Senior |
$3.65
|
| Rate for Payer: Galaxy Health WC |
$7.75
|
| Rate for Payer: Galaxy Health WC |
$11.88
|
| Rate for Payer: Galaxy Health WC |
$3.26
|
| Rate for Payer: Galaxy Health WC |
$10.62
|
| Rate for Payer: Global Benefits Group Commercial |
$5.47
|
| Rate for Payer: Global Benefits Group Commercial |
$8.39
|
| Rate for Payer: Global Benefits Group Commercial |
$2.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.94
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$9.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.69
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$6.38
|
| Rate for Payer: Multiplan Commercial |
$2.88
|
| Rate for Payer: Multiplan Commercial |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$6.84
|
| Rate for Payer: Multiplan Commercial |
$9.38
|
| Rate for Payer: Networks By Design Commercial |
$4.56
|
| Rate for Payer: Networks By Design Commercial |
$6.99
|
| Rate for Payer: Networks By Design Commercial |
$1.92
|
| Rate for Payer: Networks By Design Commercial |
$6.25
|
| Rate for Payer: Prime Health Services Commercial |
$7.75
|
| Rate for Payer: Prime Health Services Commercial |
$3.26
|
| Rate for Payer: Prime Health Services Commercial |
$10.62
|
| Rate for Payer: Prime Health Services Commercial |
$11.88
|
| Rate for Payer: Riverside University Health System MISP |
$5.00
|
| Rate for Payer: Riverside University Health System MISP |
$5.59
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Riverside University Health System MISP |
$3.65
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.50
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.39
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.47
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.42
|
| Rate for Payer: United Healthcare All Other HMO |
$3.33
|
| Rate for Payer: United Healthcare All Other HMO |
$1.40
|
| Rate for Payer: United Healthcare All Other HMO |
$4.57
|
| Rate for Payer: United Healthcare All Other HMO |
$5.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1.37
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare HMO Rider |
$5.00
|
| Rate for Payer: United Healthcare HMO Rider |
$3.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.62
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Vantage Medical Group Senior |
$7.75
|
| Rate for Payer: Vantage Medical Group Senior |
$11.88
|
| Rate for Payer: Vantage Medical Group Senior |
$3.26
|
| Rate for Payer: Vantage Medical Group Senior |
$10.62
|
|
|
METHYLPREDNISOLONE 125 MG INJ. [4081205]
|
Facility
|
IP
|
$13.98
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.80 |
| Max. Negotiated Rate |
$12.58 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Adventist Health Commercial |
$1.82
|
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Adventist Health Commercial |
$2.50
|
| Rate for Payer: Blue Shield of California Commercial |
$11.21
|
| Rate for Payer: Blue Shield of California Commercial |
$10.03
|
| Rate for Payer: Blue Shield of California Commercial |
$7.31
|
| Rate for Payer: Blue Shield of California Commercial |
$3.08
|
| Rate for Payer: Blue Shield of California EPN |
$7.05
|
| Rate for Payer: Blue Shield of California EPN |
$6.30
|
| Rate for Payer: Blue Shield of California EPN |
$1.94
|
| Rate for Payer: Blue Shield of California EPN |
$4.60
|
| Rate for Payer: Cash Price |
$4.10
|
| Rate for Payer: Cash Price |
$5.62
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Central Health Plan Commercial |
$7.30
|
| Rate for Payer: Central Health Plan Commercial |
$11.18
|
| Rate for Payer: Central Health Plan Commercial |
$10.00
|
| Rate for Payer: Central Health Plan Commercial |
$3.07
|
| Rate for Payer: Cigna of CA HMO |
$9.79
|
| Rate for Payer: Cigna of CA HMO |
$2.69
|
| Rate for Payer: Cigna of CA HMO |
$6.38
|
| Rate for Payer: Cigna of CA HMO |
$8.75
|
| Rate for Payer: Cigna of CA PPO |
$8.75
|
| Rate for Payer: Cigna of CA PPO |
$9.79
|
| Rate for Payer: Cigna of CA PPO |
$2.69
|
| Rate for Payer: Cigna of CA PPO |
$6.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.75
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$6.38
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$9.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.00
|
| Rate for Payer: EPIC Health Plan Senior |
$5.59
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$3.65
|
| Rate for Payer: EPIC Health Plan Senior |
$5.00
|
| Rate for Payer: Galaxy Health WC |
$3.26
|
| Rate for Payer: Galaxy Health WC |
$10.62
|
| Rate for Payer: Galaxy Health WC |
$11.88
|
| Rate for Payer: Galaxy Health WC |
$7.75
|
| Rate for Payer: Global Benefits Group Commercial |
$5.47
|
| Rate for Payer: Global Benefits Group Commercial |
$8.39
|
| Rate for Payer: Global Benefits Group Commercial |
$2.30
|
| Rate for Payer: Global Benefits Group Commercial |
$7.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.25
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$5.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.94
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$8.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$6.84
|
| Rate for Payer: Multiplan Commercial |
$10.48
|
| Rate for Payer: Multiplan Commercial |
$9.38
|
| Rate for Payer: Multiplan Commercial |
$2.88
|
| Rate for Payer: Networks By Design Commercial |
$4.56
|
| Rate for Payer: Networks By Design Commercial |
$6.25
|
| Rate for Payer: Networks By Design Commercial |
$1.92
|
| Rate for Payer: Networks By Design Commercial |
$6.99
|
| Rate for Payer: Prime Health Services Commercial |
$3.26
|
| Rate for Payer: Prime Health Services Commercial |
$11.88
|
| Rate for Payer: Prime Health Services Commercial |
$10.62
|
| Rate for Payer: Prime Health Services Commercial |
$7.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.25
|
| Rate for Payer: United Healthcare All Other HMO |
$5.11
|
| Rate for Payer: United Healthcare All Other HMO |
$4.57
|
| Rate for Payer: United Healthcare All Other HMO |
$3.33
|
| Rate for Payer: United Healthcare All Other HMO |
$1.40
|
| Rate for Payer: United Healthcare HMO Rider |
$4.47
|
| Rate for Payer: United Healthcare HMO Rider |
$1.37
|
| Rate for Payer: United Healthcare HMO Rider |
$3.26
|
| Rate for Payer: United Healthcare HMO Rider |
$5.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.99
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.26
|
|
|
METHYLPREDNISOLONE 16 MG TABLET [4992]
|
Facility
|
OP
|
$2.82
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$2.54 |
| Rate for Payer: Adventist Health Commercial |
$0.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.40
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.55
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.96
|
| Rate for Payer: Blue Shield of California Commercial |
$0.41
|
| Rate for Payer: Blue Shield of California EPN |
$0.37
|
| Rate for Payer: Cash Price |
$1.27
|
| Rate for Payer: Cash Price |
$1.27
|
| Rate for Payer: Central Health Plan Commercial |
$2.26
|
| Rate for Payer: Cigna of CA HMO |
$1.97
|
| Rate for Payer: Cigna of CA PPO |
$1.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.40
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.40
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.13
|
| Rate for Payer: EPIC Health Plan Senior |
$1.13
|
| Rate for Payer: Galaxy Health WC |
$2.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.97
|
| Rate for Payer: Multiplan Commercial |
$2.12
|
| Rate for Payer: Networks By Design Commercial |
$1.41
|
| Rate for Payer: Prime Health Services Commercial |
$2.40
|
| Rate for Payer: Riverside University Health System MISP |
$1.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.06
|
| Rate for Payer: United Healthcare All Other HMO |
$1.03
|
| Rate for Payer: United Healthcare HMO Rider |
$1.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.40
|
| Rate for Payer: Vantage Medical Group Senior |
$2.40
|
|
|
METHYLPREDNISOLONE 16 MG TABLET [4992]
|
Facility
|
IP
|
$2.82
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.56 |
| Max. Negotiated Rate |
$2.54 |
| Rate for Payer: Adventist Health Commercial |
$0.56
|
| Rate for Payer: Blue Shield of California Commercial |
$2.26
|
| Rate for Payer: Blue Shield of California EPN |
$1.42
|
| Rate for Payer: Cash Price |
$1.27
|
| Rate for Payer: Central Health Plan Commercial |
$2.26
|
| Rate for Payer: Cigna of CA HMO |
$1.97
|
| Rate for Payer: Cigna of CA PPO |
$1.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.97
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.13
|
| Rate for Payer: EPIC Health Plan Senior |
$1.13
|
| Rate for Payer: Galaxy Health WC |
$2.40
|
| Rate for Payer: Global Benefits Group Commercial |
$1.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.66
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.56
|
| Rate for Payer: Multiplan Commercial |
$2.12
|
| Rate for Payer: Networks By Design Commercial |
$1.41
|
| Rate for Payer: Prime Health Services Commercial |
$2.40
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.06
|
| Rate for Payer: United Healthcare All Other HMO |
$1.03
|
| Rate for Payer: United Healthcare HMO Rider |
$1.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.92
|
|
