|
CINACALCET 30 MG TABLET [38100]
|
Facility
|
IP
|
$0.60
|
|
|
Service Code
|
NDC 6909741002
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.54 |
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Blue Shield of California Commercial |
$0.48
|
| Rate for Payer: Blue Shield of California EPN |
$0.30
|
| Rate for Payer: Cash Price |
$0.27
|
| Rate for Payer: Central Health Plan Commercial |
$0.48
|
| Rate for Payer: Cigna of CA HMO |
$0.42
|
| Rate for Payer: Cigna of CA PPO |
$0.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Senior |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.51
|
| Rate for Payer: Global Benefits Group Commercial |
$0.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Commercial |
$0.45
|
| Rate for Payer: Networks By Design Commercial |
$0.39
|
| Rate for Payer: Prime Health Services Commercial |
$0.51
|
|
|
CINACALCET 30 MG TABLET [38100]
|
Facility
|
IP
|
$0.60
|
|
|
Service Code
|
NDC 1672944015
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.54 |
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Blue Shield of California Commercial |
$0.48
|
| Rate for Payer: Blue Shield of California EPN |
$0.30
|
| Rate for Payer: Cash Price |
$0.27
|
| Rate for Payer: Central Health Plan Commercial |
$0.48
|
| Rate for Payer: Cigna of CA HMO |
$0.42
|
| Rate for Payer: Cigna of CA PPO |
$0.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Senior |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.51
|
| Rate for Payer: Global Benefits Group Commercial |
$0.36
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.54
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Commercial |
$0.45
|
| Rate for Payer: Networks By Design Commercial |
$0.39
|
| Rate for Payer: Prime Health Services Commercial |
$0.51
|
|
|
CINACALCET 30 MG TABLET [38100]
|
Facility
|
IP
|
$26.50
|
|
|
Service Code
|
NDC 6068751621
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$23.85 |
| Rate for Payer: Adventist Health Commercial |
$5.30
|
| Rate for Payer: Blue Shield of California Commercial |
$21.25
|
| Rate for Payer: Blue Shield of California EPN |
$13.36
|
| Rate for Payer: Cash Price |
$11.92
|
| Rate for Payer: Central Health Plan Commercial |
$21.20
|
| Rate for Payer: Cigna of CA HMO |
$18.55
|
| Rate for Payer: Cigna of CA PPO |
$18.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10.60
|
| Rate for Payer: Galaxy Health WC |
$22.52
|
| Rate for Payer: Global Benefits Group Commercial |
$15.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.30
|
| Rate for Payer: Multiplan Commercial |
$19.88
|
| Rate for Payer: Networks By Design Commercial |
$17.23
|
| Rate for Payer: Prime Health Services Commercial |
$22.52
|
|
|
CINACALCET 30 MG TABLET [38100]
|
Facility
|
IP
|
$26.50
|
|
|
Service Code
|
NDC 6068751611
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$5.30 |
| Max. Negotiated Rate |
$23.85 |
| Rate for Payer: Adventist Health Commercial |
$5.30
|
| Rate for Payer: Blue Shield of California Commercial |
$21.25
|
| Rate for Payer: Blue Shield of California EPN |
$13.36
|
| Rate for Payer: Cash Price |
$11.92
|
| Rate for Payer: Central Health Plan Commercial |
$21.20
|
| Rate for Payer: Cigna of CA HMO |
$18.55
|
| Rate for Payer: Cigna of CA PPO |
$18.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.60
|
| Rate for Payer: EPIC Health Plan Senior |
$10.60
|
| Rate for Payer: Galaxy Health WC |
$22.52
|
| Rate for Payer: Global Benefits Group Commercial |
$15.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$23.85
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$16.83
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.63
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.30
|
| Rate for Payer: Multiplan Commercial |
$19.88
|
| Rate for Payer: Networks By Design Commercial |
$17.23
|
| Rate for Payer: Prime Health Services Commercial |
$22.52
|
|
|
CINACALCET 30 MG TABLET [38100]
|
Facility
|
OP
|
$0.59
|
|
|
Service Code
|
NDC 6787750330
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.53 |
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.34
|
| Rate for Payer: Blue Shield of California Commercial |
$0.37
|
| Rate for Payer: Blue Shield of California EPN |
$0.24
|
| Rate for Payer: Cash Price |
$0.27
|
| Rate for Payer: Central Health Plan Commercial |
$0.47
|
| Rate for Payer: Cigna of CA HMO |
$0.41
|
| Rate for Payer: Cigna of CA PPO |
$0.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Senior |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.50
|
| Rate for Payer: Global Benefits Group Commercial |
$0.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$0.44
|
| Rate for Payer: Networks By Design Commercial |
$0.38
|
| Rate for Payer: Prime Health Services Commercial |
$0.50
|
| Rate for Payer: Riverside University Health System MISP |
$0.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.30
|
| Rate for Payer: United Healthcare All Other HMO |
$0.30
|
| Rate for Payer: United Healthcare HMO Rider |
$0.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.50
|
| Rate for Payer: Vantage Medical Group Senior |
$0.50
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 6787750430
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.87
|
| Rate for Payer: Blue Shield of California EPN |
$0.54
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 6438088404
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.63
|
| Rate for Payer: Blue Shield of California Commercial |
$0.68
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
| Rate for Payer: Riverside University Health System MISP |
$0.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.54
|
| Rate for Payer: United Healthcare All Other HMO |
$0.54
|
| Rate for Payer: United Healthcare HMO Rider |
$0.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 6909741102
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.63
|
| Rate for Payer: Blue Shield of California Commercial |
$0.68
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
| Rate for Payer: Riverside University Health System MISP |
$0.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.54
|
| Rate for Payer: United Healthcare All Other HMO |
$0.54
|
| Rate for Payer: United Healthcare HMO Rider |
$0.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$64.54
|
|
|
Service Code
|
NDC 5551307430
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$58.09 |
| Rate for Payer: Adventist Health Commercial |
$12.91
|
| Rate for Payer: Blue Shield of California Commercial |
$51.76
|
| Rate for Payer: Blue Shield of California EPN |
$32.53
|
| Rate for Payer: Cash Price |
$29.04
|
| Rate for Payer: Central Health Plan Commercial |
$51.63
|
| Rate for Payer: Cigna of CA HMO |
$45.18
|
| Rate for Payer: Cigna of CA PPO |
$45.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.82
|
| Rate for Payer: EPIC Health Plan Senior |
$25.82
|
| Rate for Payer: Galaxy Health WC |
$54.86
|
| Rate for Payer: Global Benefits Group Commercial |
$38.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.91
|
| Rate for Payer: Multiplan Commercial |
$48.41
|
| Rate for Payer: Networks By Design Commercial |
$41.95
|
| Rate for Payer: Prime Health Services Commercial |
$54.86
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 1672944110
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.63
|
| Rate for Payer: Blue Shield of California Commercial |
$0.68
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
| Rate for Payer: Riverside University Health System MISP |
$0.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.54
|
| Rate for Payer: United Healthcare All Other HMO |
$0.54
|
| Rate for Payer: United Healthcare HMO Rider |
$0.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 6586283230
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.63
|
| Rate for Payer: Blue Shield of California Commercial |
$0.68
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
| Rate for Payer: Riverside University Health System MISP |
$0.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.54
|
| Rate for Payer: United Healthcare All Other HMO |
$0.54
|
| Rate for Payer: United Healthcare HMO Rider |
$0.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 6586283230
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.87
|
| Rate for Payer: Blue Shield of California EPN |
$0.54
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 6787750430
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.63
|
| Rate for Payer: Blue Shield of California Commercial |
$0.68
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
| Rate for Payer: Riverside University Health System MISP |
$0.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.54
|
| Rate for Payer: United Healthcare All Other HMO |
$0.54
|
| Rate for Payer: United Healthcare HMO Rider |
$0.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 7043600804
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.87
|
| Rate for Payer: Blue Shield of California EPN |
$0.54
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 1672944110
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.87
|
| Rate for Payer: Blue Shield of California EPN |
$0.54
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 7043600804
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.66
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.63
|
| Rate for Payer: Blue Shield of California Commercial |
$0.68
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
| Rate for Payer: Riverside University Health System MISP |
$0.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.54
|
| Rate for Payer: United Healthcare All Other HMO |
$0.54
|
| Rate for Payer: United Healthcare HMO Rider |
$0.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 6909741102
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.87
|
| Rate for Payer: Blue Shield of California EPN |
$0.54
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 6438088404
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$0.97 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.87
|
| Rate for Payer: Blue Shield of California EPN |
$0.54
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Central Health Plan Commercial |
$0.86
|
| Rate for Payer: Cigna of CA HMO |
$0.76
|
| Rate for Payer: Cigna of CA PPO |
$0.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.43
|
| Rate for Payer: EPIC Health Plan Senior |
$0.43
|
| Rate for Payer: Galaxy Health WC |
$0.92
|
| Rate for Payer: Global Benefits Group Commercial |
$0.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: Networks By Design Commercial |
$0.70
|
| Rate for Payer: Prime Health Services Commercial |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$64.54
|
|
|
Service Code
|
NDC 5551307430
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$12.91 |
| Max. Negotiated Rate |
$58.09 |
| Rate for Payer: Adventist Health Commercial |
$12.91
|
| Rate for Payer: Aetna of CA HMO/PPO |
$39.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$37.54
|
| Rate for Payer: Blue Shield of California Commercial |
$40.92
|
| Rate for Payer: Blue Shield of California EPN |
$25.75
|
| Rate for Payer: Cash Price |
$29.04
|
| Rate for Payer: Central Health Plan Commercial |
$51.63
|
| Rate for Payer: Cigna of CA HMO |
$45.18
|
| Rate for Payer: Cigna of CA PPO |
$45.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$54.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$54.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$45.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.82
|
| Rate for Payer: EPIC Health Plan Senior |
$25.82
|
| Rate for Payer: Galaxy Health WC |
$54.86
|
| Rate for Payer: Global Benefits Group Commercial |
$38.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$58.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$40.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.91
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45.18
|
| Rate for Payer: Multiplan Commercial |
$48.41
|
| Rate for Payer: Networks By Design Commercial |
$41.95
|
| Rate for Payer: Prime Health Services Commercial |
$54.86
|
| Rate for Payer: Riverside University Health System MISP |
$25.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$38.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$38.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$32.27
|
| Rate for Payer: United Healthcare All Other HMO |
$32.27
|
| Rate for Payer: United Healthcare HMO Rider |
$32.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$32.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$54.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.86
|
| Rate for Payer: Vantage Medical Group Senior |
$54.86
|
|
|
CINACALCET 90 MG TABLET [38102]
|
Facility
|
OP
|
$96.80
|
|
|
Service Code
|
NDC 5551307530
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$19.36 |
| Max. Negotiated Rate |
$87.12 |
| Rate for Payer: Adventist Health Commercial |
$19.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$58.79
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$72.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.87
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.31
|
| Rate for Payer: Blue Shield of California Commercial |
$61.37
|
| Rate for Payer: Blue Shield of California EPN |
$38.62
|
| Rate for Payer: Cash Price |
$43.56
|
| Rate for Payer: Central Health Plan Commercial |
$77.44
|
| Rate for Payer: Cigna of CA HMO |
$67.76
|
| Rate for Payer: Cigna of CA PPO |
$67.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$82.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$82.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$82.28
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.72
|
| Rate for Payer: EPIC Health Plan Senior |
$38.72
|
| Rate for Payer: Galaxy Health WC |
$82.28
|
| Rate for Payer: Global Benefits Group Commercial |
$58.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$61.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.14
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.36
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$67.76
|
| Rate for Payer: Multiplan Commercial |
$72.60
|
| Rate for Payer: Networks By Design Commercial |
$62.92
|
| Rate for Payer: Prime Health Services Commercial |
$82.28
|
| Rate for Payer: Riverside University Health System MISP |
$38.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$58.08
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$58.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.40
|
| Rate for Payer: United Healthcare All Other HMO |
$48.40
|
| Rate for Payer: United Healthcare HMO Rider |
$48.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$82.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$82.28
|
| Rate for Payer: Vantage Medical Group Senior |
$82.28
|
|
|
CINACALCET 90 MG TABLET [38102]
|
Facility
|
IP
|
$1.56
|
|
|
Service Code
|
NDC 6787750530
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$1.40 |
| Rate for Payer: Adventist Health Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California Commercial |
$1.25
|
| Rate for Payer: Blue Shield of California EPN |
$0.79
|
| Rate for Payer: Cash Price |
$0.70
|
| Rate for Payer: Central Health Plan Commercial |
$1.25
|
| Rate for Payer: Cigna of CA HMO |
$1.09
|
| Rate for Payer: Cigna of CA PPO |
$1.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.62
|
| Rate for Payer: EPIC Health Plan Senior |
$0.62
|
| Rate for Payer: Galaxy Health WC |
$1.33
|
| Rate for Payer: Global Benefits Group Commercial |
$0.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.31
|
| Rate for Payer: Multiplan Commercial |
$1.17
|
| Rate for Payer: Networks By Design Commercial |
$1.01
|
| Rate for Payer: Prime Health Services Commercial |
$1.33
|
|
|
CINACALCET 90 MG TABLET [38102]
|
Facility
|
IP
|
$96.80
|
|
|
Service Code
|
NDC 5551307530
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$19.36 |
| Max. Negotiated Rate |
$87.12 |
| Rate for Payer: Adventist Health Commercial |
$19.36
|
| Rate for Payer: Blue Shield of California Commercial |
$77.63
|
| Rate for Payer: Blue Shield of California EPN |
$48.79
|
| Rate for Payer: Cash Price |
$43.56
|
| Rate for Payer: Central Health Plan Commercial |
$77.44
|
| Rate for Payer: Cigna of CA HMO |
$67.76
|
| Rate for Payer: Cigna of CA PPO |
$67.76
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$67.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.72
|
| Rate for Payer: EPIC Health Plan Senior |
$38.72
|
| Rate for Payer: Galaxy Health WC |
$82.28
|
| Rate for Payer: Global Benefits Group Commercial |
$58.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$87.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$61.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$57.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.36
|
| Rate for Payer: Multiplan Commercial |
$72.60
|
| Rate for Payer: Networks By Design Commercial |
$62.92
|
| Rate for Payer: Prime Health Services Commercial |
$82.28
|
|
|
CINACALCET 90 MG TABLET [38102]
|
Facility
|
OP
|
$1.56
|
|
|
Service Code
|
NDC 6787750530
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$1.40 |
| Rate for Payer: Adventist Health Commercial |
$0.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.95
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.91
|
| Rate for Payer: Blue Shield of California Commercial |
$0.99
|
| Rate for Payer: Blue Shield of California EPN |
$0.62
|
| Rate for Payer: Cash Price |
$0.70
|
| Rate for Payer: Central Health Plan Commercial |
$1.25
|
| Rate for Payer: Cigna of CA HMO |
$1.09
|
| Rate for Payer: Cigna of CA PPO |
$1.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.62
|
| Rate for Payer: EPIC Health Plan Senior |
$0.62
|
| Rate for Payer: Galaxy Health WC |
$1.33
|
| Rate for Payer: Global Benefits Group Commercial |
$0.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.31
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.09
|
| Rate for Payer: Multiplan Commercial |
$1.17
|
| Rate for Payer: Networks By Design Commercial |
$1.01
|
| Rate for Payer: Prime Health Services Commercial |
$1.33
|
| Rate for Payer: Riverside University Health System MISP |
$0.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.78
|
| Rate for Payer: United Healthcare All Other HMO |
$0.78
|
| Rate for Payer: United Healthcare HMO Rider |
$0.78
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.33
|
| Rate for Payer: Vantage Medical Group Senior |
$1.33
|
|
|
CIPROFLOXACIN 0.2 %-HYDROCORTISONE 1 % EAR DROPS,SUSPENSION [22986]
|
Facility
|
OP
|
$39.36
|
|
|
Service Code
|
NDC 0713085109
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$35.42 |
| Rate for Payer: Adventist Health Commercial |
$7.87
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.90
|
| Rate for Payer: Blue Shield of California Commercial |
$24.95
|
| Rate for Payer: Blue Shield of California EPN |
$15.70
|
| Rate for Payer: Cash Price |
$17.71
|
| Rate for Payer: Central Health Plan Commercial |
$31.49
|
| Rate for Payer: Cigna of CA HMO |
$27.55
|
| Rate for Payer: Cigna of CA PPO |
$27.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.74
|
| Rate for Payer: EPIC Health Plan Senior |
$15.74
|
| Rate for Payer: Galaxy Health WC |
$33.46
|
| Rate for Payer: Global Benefits Group Commercial |
$23.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$14.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.55
|
| Rate for Payer: Multiplan Commercial |
$29.52
|
| Rate for Payer: Networks By Design Commercial |
$25.58
|
| Rate for Payer: Prime Health Services Commercial |
$33.46
|
| Rate for Payer: Riverside University Health System MISP |
$15.74
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.68
|
| Rate for Payer: United Healthcare All Other HMO |
$19.68
|
| Rate for Payer: United Healthcare HMO Rider |
$19.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.46
|
| Rate for Payer: Vantage Medical Group Senior |
$33.46
|
|
|
CIPROFLOXACIN 0.2 %-HYDROCORTISONE 1 % EAR DROPS,SUSPENSION [22986]
|
Facility
|
IP
|
$39.36
|
|
|
Service Code
|
NDC 0713085109
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.87 |
| Max. Negotiated Rate |
$35.42 |
| Rate for Payer: Adventist Health Commercial |
$7.87
|
| Rate for Payer: Blue Shield of California Commercial |
$31.57
|
| Rate for Payer: Blue Shield of California EPN |
$19.84
|
| Rate for Payer: Cash Price |
$17.71
|
| Rate for Payer: Central Health Plan Commercial |
$31.49
|
| Rate for Payer: Cigna of CA HMO |
$27.55
|
| Rate for Payer: Cigna of CA PPO |
$27.55
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$27.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.74
|
| Rate for Payer: EPIC Health Plan Senior |
$15.74
|
| Rate for Payer: Galaxy Health WC |
$33.46
|
| Rate for Payer: Global Benefits Group Commercial |
$23.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$35.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$24.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.87
|
| Rate for Payer: Multiplan Commercial |
$29.52
|
| Rate for Payer: Networks By Design Commercial |
$25.58
|
| Rate for Payer: Prime Health Services Commercial |
$33.46
|
|
