|
OXYTOCIN 30 UNIT/500 ML IN 0.9 % SODIUM CHLORIDE IV (TITRATABLE) [4085635]
|
Facility
|
OP
|
$0.07
|
|
|
Service Code
|
HCPCS J2590
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$13.45 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.05
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.24
|
| Rate for Payer: Blue Shield of California Commercial |
$1.85
|
| Rate for Payer: Blue Shield of California EPN |
$1.68
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Central Health Plan Commercial |
$0.06
|
| Rate for Payer: Cigna of CA HMO |
$0.05
|
| Rate for Payer: Cigna of CA PPO |
$0.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: EPIC Health Plan Senior |
$0.03
|
| Rate for Payer: Galaxy Health WC |
$0.06
|
| Rate for Payer: Global Benefits Group Commercial |
$0.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Prime Health Services Commercial |
$0.06
|
| Rate for Payer: Riverside University Health System MISP |
$0.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.06
|
| Rate for Payer: Vantage Medical Group Senior |
$0.06
|
|
|
PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS [10843]
|
Facility
|
IP
|
$1.71
|
|
|
Service Code
|
HCPCS J9267
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$1.54 |
| Rate for Payer: Adventist Health Commercial |
$0.34
|
| Rate for Payer: Adventist Health Commercial |
$0.48
|
| Rate for Payer: Adventist Health Commercial |
$0.41
|
| Rate for Payer: Adventist Health Commercial |
$0.29
|
| Rate for Payer: Blue Shield of California Commercial |
$1.37
|
| Rate for Payer: Blue Shield of California Commercial |
$1.15
|
| Rate for Payer: Blue Shield of California Commercial |
$1.92
|
| Rate for Payer: Blue Shield of California Commercial |
$1.63
|
| Rate for Payer: Blue Shield of California EPN |
$0.86
|
| Rate for Payer: Blue Shield of California EPN |
$0.73
|
| Rate for Payer: Blue Shield of California EPN |
$1.02
|
| Rate for Payer: Blue Shield of California EPN |
$1.21
|
| Rate for Payer: Cash Price |
$1.08
|
| Rate for Payer: Cash Price |
$0.65
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Central Health Plan Commercial |
$1.92
|
| Rate for Payer: Central Health Plan Commercial |
$1.37
|
| Rate for Payer: Central Health Plan Commercial |
$1.15
|
| Rate for Payer: Central Health Plan Commercial |
$1.62
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA HMO |
$1.42
|
| Rate for Payer: Cigna of CA HMO |
$1.68
|
| Rate for Payer: Cigna of CA HMO |
$1.01
|
| Rate for Payer: Cigna of CA PPO |
$1.01
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Cigna of CA PPO |
$1.42
|
| Rate for Payer: Cigna of CA PPO |
$1.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.58
|
| Rate for Payer: EPIC Health Plan Senior |
$0.68
|
| Rate for Payer: EPIC Health Plan Senior |
$0.81
|
| Rate for Payer: EPIC Health Plan Senior |
$0.96
|
| Rate for Payer: EPIC Health Plan Senior |
$0.58
|
| Rate for Payer: Galaxy Health WC |
$1.73
|
| Rate for Payer: Galaxy Health WC |
$1.22
|
| Rate for Payer: Galaxy Health WC |
$1.45
|
| Rate for Payer: Galaxy Health WC |
$2.04
|
| Rate for Payer: Global Benefits Group Commercial |
$1.44
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Global Benefits Group Commercial |
$1.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.29
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$1.80
|
| Rate for Payer: Multiplan Commercial |
$1.28
|
| Rate for Payer: Multiplan Commercial |
$1.08
|
| Rate for Payer: Multiplan Commercial |
$1.52
|
| Rate for Payer: Networks By Design Commercial |
$1.20
|
| Rate for Payer: Networks By Design Commercial |
$0.72
|
| Rate for Payer: Networks By Design Commercial |
$1.01
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Prime Health Services Commercial |
$1.73
|
| Rate for Payer: Prime Health Services Commercial |
$1.45
|
| Rate for Payer: Prime Health Services Commercial |
$1.22
|
| Rate for Payer: Prime Health Services Commercial |
$2.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.64
|
| Rate for Payer: United Healthcare All Other HMO |
$0.62
|
| Rate for Payer: United Healthcare All Other HMO |
$0.53
|
| Rate for Payer: United Healthcare All Other HMO |
$0.88
|
| Rate for Payer: United Healthcare All Other HMO |
$0.74
|
| Rate for Payer: United Healthcare HMO Rider |
$0.51
|
| Rate for Payer: United Healthcare HMO Rider |
$0.73
|
| Rate for Payer: United Healthcare HMO Rider |
$0.86
|
| Rate for Payer: United Healthcare HMO Rider |
$0.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.66
|
|
|
PACLITAXEL 6 MG/ML CONCENTRATE,INTRAVENOUS [10843]
|
Facility
|
OP
|
$2.40
|
|
|
Service Code
|
HCPCS J9267
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$2.16 |
| Rate for Payer: Adventist Health Commercial |
$0.48
|
| Rate for Payer: Adventist Health Commercial |
$0.34
|
| Rate for Payer: Adventist Health Commercial |
$0.29
|
| Rate for Payer: Adventist Health Commercial |
$0.41
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.25
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.73
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.45
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.94
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.80
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.12
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.39
|
| Rate for Payer: Blue Shield of California EPN |
$0.39
|
| Rate for Payer: Blue Shield of California EPN |
$0.39
|
| Rate for Payer: Blue Shield of California EPN |
$0.39
|
| Rate for Payer: Cash Price |
$0.65
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Cash Price |
$0.65
|
| Rate for Payer: Cash Price |
$1.08
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$0.77
|
| Rate for Payer: Cash Price |
$1.08
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Central Health Plan Commercial |
$1.15
|
| Rate for Payer: Central Health Plan Commercial |
$1.92
|
| Rate for Payer: Central Health Plan Commercial |
$1.62
|
| Rate for Payer: Central Health Plan Commercial |
$1.37
|
| Rate for Payer: Cigna of CA HMO |
$1.20
|
| Rate for Payer: Cigna of CA HMO |
$1.42
|
| Rate for Payer: Cigna of CA HMO |
$1.68
|
| Rate for Payer: Cigna of CA HMO |
$1.01
|
| Rate for Payer: Cigna of CA PPO |
$1.42
|
| Rate for Payer: Cigna of CA PPO |
$1.68
|
| Rate for Payer: Cigna of CA PPO |
$1.01
|
| Rate for Payer: Cigna of CA PPO |
$1.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.45
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.04
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.73
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.42
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.68
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.58
|
| Rate for Payer: EPIC Health Plan Senior |
$0.81
|
| Rate for Payer: EPIC Health Plan Senior |
$0.58
|
| Rate for Payer: EPIC Health Plan Senior |
$0.68
|
| Rate for Payer: EPIC Health Plan Senior |
$0.96
|
| Rate for Payer: Galaxy Health WC |
$2.04
|
| Rate for Payer: Galaxy Health WC |
$1.45
|
| Rate for Payer: Galaxy Health WC |
$1.73
|
| Rate for Payer: Galaxy Health WC |
$1.22
|
| Rate for Payer: Global Benefits Group Commercial |
$1.44
|
| Rate for Payer: Global Benefits Group Commercial |
$1.03
|
| Rate for Payer: Global Benefits Group Commercial |
$1.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.86
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.54
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.11
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.09
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.68
|
| Rate for Payer: Multiplan Commercial |
$1.52
|
| Rate for Payer: Multiplan Commercial |
$1.28
|
| Rate for Payer: Multiplan Commercial |
$1.80
|
| Rate for Payer: Multiplan Commercial |
$1.08
|
| Rate for Payer: Networks By Design Commercial |
$1.20
|
| Rate for Payer: Networks By Design Commercial |
$0.86
|
| Rate for Payer: Networks By Design Commercial |
$1.01
|
| Rate for Payer: Networks By Design Commercial |
$0.72
|
| Rate for Payer: Prime Health Services Commercial |
$2.04
|
| Rate for Payer: Prime Health Services Commercial |
$1.73
|
| Rate for Payer: Prime Health Services Commercial |
$1.22
|
| Rate for Payer: Prime Health Services Commercial |
$1.45
|
| Rate for Payer: Riverside University Health System MISP |
$0.58
|
| Rate for Payer: Riverside University Health System MISP |
$0.68
|
| Rate for Payer: Riverside University Health System MISP |
$0.81
|
| Rate for Payer: Riverside University Health System MISP |
$0.96
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.86
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.54
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.64
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.90
|
| Rate for Payer: United Healthcare All Other HMO |
$0.88
|
| Rate for Payer: United Healthcare All Other HMO |
$0.74
|
| Rate for Payer: United Healthcare All Other HMO |
$0.53
|
| Rate for Payer: United Healthcare All Other HMO |
$0.62
|
| Rate for Payer: United Healthcare HMO Rider |
$0.73
|
| Rate for Payer: United Healthcare HMO Rider |
$0.51
|
| Rate for Payer: United Healthcare HMO Rider |
$0.61
|
| Rate for Payer: United Healthcare HMO Rider |
$0.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.47
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.73
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.45
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.45
|
| Rate for Payer: Vantage Medical Group Senior |
$2.04
|
| Rate for Payer: Vantage Medical Group Senior |
$1.45
|
| Rate for Payer: Vantage Medical Group Senior |
$1.73
|
| Rate for Payer: Vantage Medical Group Senior |
$1.22
|
|
|
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION [40475]
|
Facility
|
OP
|
$1,896.07
|
|
|
Service Code
|
HCPCS J9264
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.59 |
| Max. Negotiated Rate |
$1,706.46 |
| Rate for Payer: Adventist Health Commercial |
$379.21
|
| Rate for Payer: Adventist Health Commercial |
$341.29
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.59
|
| Rate for Payer: Adventist Health Medi-Cal |
$6.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.72
|
| Rate for Payer: Aetna of CA HMO/PPO |
$25.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.59
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.70
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.09
|
| Rate for Payer: Blue Shield of California Commercial |
$20.47
|
| Rate for Payer: Blue Shield of California Commercial |
$20.47
|
| Rate for Payer: Blue Shield of California EPN |
$18.61
|
| Rate for Payer: Blue Shield of California EPN |
$18.61
|
| Rate for Payer: Cash Price |
$853.23
|
| Rate for Payer: Cash Price |
$767.91
|
| Rate for Payer: Cash Price |
$767.91
|
| Rate for Payer: Cash Price |
$853.23
|
| Rate for Payer: Central Health Plan Commercial |
$1,516.86
|
| Rate for Payer: Central Health Plan Commercial |
$1,365.17
|
| Rate for Payer: Cigna of CA HMO |
$1,327.25
|
| Rate for Payer: Cigna of CA HMO |
$1,194.52
|
| Rate for Payer: Cigna of CA PPO |
$1,327.25
|
| Rate for Payer: Cigna of CA PPO |
$1,194.52
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,194.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,327.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.87
|
| Rate for Payer: EPIC Health Plan Senior |
$7.25
|
| Rate for Payer: EPIC Health Plan Senior |
$7.25
|
| Rate for Payer: Galaxy Health WC |
$1,450.49
|
| Rate for Payer: Galaxy Health WC |
$1,611.66
|
| Rate for Payer: Global Benefits Group Commercial |
$1,137.64
|
| Rate for Payer: Global Benefits Group Commercial |
$1,023.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,535.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,706.46
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.81
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10.81
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,083.60
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,204.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.54
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$341.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$379.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.83
|
| Rate for Payer: Multiplan Commercial |
$1,279.85
|
| Rate for Payer: Multiplan Commercial |
$1,422.05
|
| Rate for Payer: Networks By Design Commercial |
$853.23
|
| Rate for Payer: Networks By Design Commercial |
$948.03
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.59
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6.59
|
| Rate for Payer: Prime Health Services Commercial |
$1,450.49
|
| Rate for Payer: Prime Health Services Commercial |
$1,611.66
|
| Rate for Payer: Prime Health Services Medicare |
$6.99
|
| Rate for Payer: Prime Health Services Medicare |
$6.99
|
| Rate for Payer: Riverside University Health System MISP |
$7.25
|
| Rate for Payer: Riverside University Health System MISP |
$7.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,023.88
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,137.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,137.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,023.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$640.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$711.60
|
| Rate for Payer: United Healthcare All Other HMO |
$623.37
|
| Rate for Payer: United Healthcare All Other HMO |
$692.63
|
| Rate for Payer: United Healthcare HMO Rider |
$677.66
|
| Rate for Payer: United Healthcare HMO Rider |
$609.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$620.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.87
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.59
|
| Rate for Payer: Upland Medical Group Pediatric |
$6.59
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.25
|
| Rate for Payer: Vantage Medical Group Senior |
$7.25
|
| Rate for Payer: Vantage Medical Group Senior |
$7.25
|
|
|
PACLITAXEL PROTEIN-BOUND 100 MG INTRAVENOUS SUSPENSION [40475]
|
Facility
|
IP
|
$1,896.07
|
|
|
Service Code
|
HCPCS J9264
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$379.21 |
| Max. Negotiated Rate |
$1,706.46 |
| Rate for Payer: Adventist Health Commercial |
$379.21
|
| Rate for Payer: Adventist Health Commercial |
$341.29
|
| Rate for Payer: Blue Shield of California Commercial |
$1,520.65
|
| Rate for Payer: Blue Shield of California Commercial |
$1,368.58
|
| Rate for Payer: Blue Shield of California EPN |
$860.06
|
| Rate for Payer: Blue Shield of California EPN |
$955.62
|
| Rate for Payer: Cash Price |
$853.23
|
| Rate for Payer: Cash Price |
$767.91
|
| Rate for Payer: Central Health Plan Commercial |
$1,516.86
|
| Rate for Payer: Central Health Plan Commercial |
$1,365.17
|
| Rate for Payer: Cigna of CA HMO |
$1,194.52
|
| Rate for Payer: Cigna of CA HMO |
$1,327.25
|
| Rate for Payer: Cigna of CA PPO |
$1,194.52
|
| Rate for Payer: Cigna of CA PPO |
$1,327.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,194.52
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,327.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$682.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$758.43
|
| Rate for Payer: EPIC Health Plan Senior |
$682.58
|
| Rate for Payer: EPIC Health Plan Senior |
$758.43
|
| Rate for Payer: Galaxy Health WC |
$1,611.66
|
| Rate for Payer: Galaxy Health WC |
$1,450.49
|
| Rate for Payer: Global Benefits Group Commercial |
$1,023.88
|
| Rate for Payer: Global Benefits Group Commercial |
$1,137.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,535.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,706.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,204.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,083.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,006.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,118.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$379.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$341.29
|
| Rate for Payer: Multiplan Commercial |
$1,279.85
|
| Rate for Payer: Multiplan Commercial |
$1,422.05
|
| Rate for Payer: Networks By Design Commercial |
$853.23
|
| Rate for Payer: Networks By Design Commercial |
$948.03
|
| Rate for Payer: Prime Health Services Commercial |
$1,611.66
|
| Rate for Payer: Prime Health Services Commercial |
$1,450.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$640.43
|
| Rate for Payer: United Healthcare All Other Commercial |
$711.60
|
| Rate for Payer: United Healthcare All Other HMO |
$692.63
|
| Rate for Payer: United Healthcare All Other HMO |
$623.37
|
| Rate for Payer: United Healthcare HMO Rider |
$609.89
|
| Rate for Payer: United Healthcare HMO Rider |
$677.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$558.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$620.96
|
|
|
PALATOPLASTY FOR CLEFT PALATE; ATTACHMENT PHARYNGEAL FLAP
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 42225
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,088.61 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Vantage Medical Group Senior |
$7,613.89
|
| Rate for Payer: Adventist Health Medi-Cal |
$7,613.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,613.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,976.10
|
| Rate for Payer: Blue Shield of California Commercial |
$9,831.25
|
| Rate for Payer: Blue Shield of California EPN |
$6,179.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,375.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,613.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,562.92
|
| Rate for Payer: EPIC Health Plan Senior |
$8,375.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,486.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,088.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,202.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,659.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,202.61
|
| Rate for Payer: Multiplan WC |
$11,976.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Preferred Health Network WC |
$12,220.51
|
| Rate for Payer: Prime Health Services Medicare |
$8,070.72
|
| Rate for Payer: Prime Health Services WC |
$11,853.89
|
| Rate for Payer: Riverside University Health System MISP |
$8,375.28
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,613.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,420.83
|
|
|
PALIFERMIN 5.16 MG INTRAVENOUS SOLUTION [239790]
|
Facility
|
IP
|
$4,601.84
|
|
|
Service Code
|
HCPCS J2425
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$920.37 |
| Max. Negotiated Rate |
$4,141.66 |
| Rate for Payer: Adventist Health Commercial |
$920.37
|
| Rate for Payer: Blue Shield of California Commercial |
$3,690.68
|
| Rate for Payer: Blue Shield of California EPN |
$2,319.33
|
| Rate for Payer: Cash Price |
$2,070.83
|
| Rate for Payer: Central Health Plan Commercial |
$3,681.47
|
| Rate for Payer: Cigna of CA HMO |
$3,221.29
|
| Rate for Payer: Cigna of CA PPO |
$3,221.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,221.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,840.74
|
| Rate for Payer: EPIC Health Plan Senior |
$1,840.74
|
| Rate for Payer: Galaxy Health WC |
$3,911.56
|
| Rate for Payer: Global Benefits Group Commercial |
$2,761.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,141.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,922.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2,715.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$920.37
|
| Rate for Payer: Multiplan Commercial |
$3,451.38
|
| Rate for Payer: Networks By Design Commercial |
$2,300.92
|
| Rate for Payer: Prime Health Services Commercial |
$3,911.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,727.07
|
| Rate for Payer: United Healthcare All Other HMO |
$1,681.05
|
| Rate for Payer: United Healthcare HMO Rider |
$1,644.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,507.10
|
|
|
PALIFERMIN 5.16 MG INTRAVENOUS SOLUTION [239790]
|
Facility
|
OP
|
$4,601.84
|
|
|
Service Code
|
HCPCS J2425
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$22.70 |
| Max. Negotiated Rate |
$4,141.66 |
| Rate for Payer: Adventist Health Commercial |
$920.37
|
| Rate for Payer: Adventist Health Medi-Cal |
$38.69
|
| Rate for Payer: Aetna of CA HMO/PPO |
$210.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$48.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$42.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.56
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$22.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$28.33
|
| Rate for Payer: Blue Shield of California Commercial |
$42.38
|
| Rate for Payer: Blue Shield of California EPN |
$38.53
|
| Rate for Payer: Cash Price |
$2,070.83
|
| Rate for Payer: Cash Price |
$2,070.83
|
| Rate for Payer: Central Health Plan Commercial |
$3,681.47
|
| Rate for Payer: Cigna of CA HMO |
$3,221.29
|
| Rate for Payer: Cigna of CA PPO |
$3,221.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$48.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.56
|
| Rate for Payer: Dignity Health Medicare Advantage |
$42.56
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3,221.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$63.84
|
| Rate for Payer: EPIC Health Plan Senior |
$42.56
|
| Rate for Payer: Galaxy Health WC |
$3,911.56
|
| Rate for Payer: Global Benefits Group Commercial |
$2,761.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$4,141.66
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$63.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$38.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2,922.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$69.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$54.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$920.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$51.84
|
| Rate for Payer: Multiplan Commercial |
$3,451.38
|
| Rate for Payer: Networks By Design Commercial |
$2,300.92
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$38.69
|
| Rate for Payer: Prime Health Services Commercial |
$3,911.56
|
| Rate for Payer: Prime Health Services Medicare |
$41.01
|
| Rate for Payer: Riverside University Health System MISP |
$42.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2,761.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2,761.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,727.07
|
| Rate for Payer: United Healthcare All Other HMO |
$1,681.05
|
| Rate for Payer: United Healthcare HMO Rider |
$1,644.70
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1,507.10
|
| Rate for Payer: Upland Medical Group Pediatric |
$38.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$48.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.56
|
| Rate for Payer: Vantage Medical Group Senior |
$42.56
|
|
|
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE [99702]
|
Facility
|
OP
|
$2,923.92
|
|
|
Service Code
|
HCPCS J2426
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$2,631.53 |
| Rate for Payer: Adventist Health Commercial |
$584.78
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.69
|
| Rate for Payer: Blue Shield of California Commercial |
$19.62
|
| Rate for Payer: Blue Shield of California EPN |
$17.84
|
| Rate for Payer: Cash Price |
$1,315.76
|
| Rate for Payer: Cash Price |
$1,315.76
|
| Rate for Payer: Central Health Plan Commercial |
$2,339.14
|
| Rate for Payer: Cigna of CA HMO |
$2,046.74
|
| Rate for Payer: Cigna of CA PPO |
$2,046.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,046.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.46
|
| Rate for Payer: EPIC Health Plan Senior |
$16.97
|
| Rate for Payer: Galaxy Health WC |
$2,485.33
|
| Rate for Payer: Global Benefits Group Commercial |
$1,754.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,631.53
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$25.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,856.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$584.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.68
|
| Rate for Payer: Multiplan Commercial |
$2,192.94
|
| Rate for Payer: Networks By Design Commercial |
$1,461.96
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.43
|
| Rate for Payer: Prime Health Services Commercial |
$2,485.33
|
| Rate for Payer: Prime Health Services Medicare |
$16.36
|
| Rate for Payer: Riverside University Health System MISP |
$16.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,754.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,754.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,097.35
|
| Rate for Payer: United Healthcare All Other HMO |
$1,068.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1,045.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$957.58
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.97
|
| Rate for Payer: Vantage Medical Group Senior |
$16.97
|
|
|
PALIPERIDONE PALMITATE 156 MG/ML INTRAMUSCULAR SYRINGE [99702]
|
Facility
|
IP
|
$2,923.92
|
|
|
Service Code
|
HCPCS J2426
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$584.78 |
| Max. Negotiated Rate |
$2,631.53 |
| Rate for Payer: Adventist Health Commercial |
$584.78
|
| Rate for Payer: Blue Shield of California Commercial |
$2,344.98
|
| Rate for Payer: Blue Shield of California EPN |
$1,473.66
|
| Rate for Payer: Cash Price |
$1,315.76
|
| Rate for Payer: Central Health Plan Commercial |
$2,339.14
|
| Rate for Payer: Cigna of CA HMO |
$2,046.74
|
| Rate for Payer: Cigna of CA PPO |
$2,046.74
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,046.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,169.57
|
| Rate for Payer: EPIC Health Plan Senior |
$1,169.57
|
| Rate for Payer: Galaxy Health WC |
$2,485.33
|
| Rate for Payer: Global Benefits Group Commercial |
$1,754.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,631.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,856.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,725.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$584.78
|
| Rate for Payer: Multiplan Commercial |
$2,192.94
|
| Rate for Payer: Networks By Design Commercial |
$1,461.96
|
| Rate for Payer: Prime Health Services Commercial |
$2,485.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,097.35
|
| Rate for Payer: United Healthcare All Other HMO |
$1,068.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1,045.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$957.58
|
|
|
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE [108109]
|
Facility
|
IP
|
$2,923.85
|
|
|
Service Code
|
HCPCS J2426
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$584.77 |
| Max. Negotiated Rate |
$2,631.47 |
| Rate for Payer: Adventist Health Commercial |
$584.77
|
| Rate for Payer: Blue Shield of California Commercial |
$2,344.93
|
| Rate for Payer: Blue Shield of California EPN |
$1,473.62
|
| Rate for Payer: Cash Price |
$1,315.73
|
| Rate for Payer: Central Health Plan Commercial |
$2,339.08
|
| Rate for Payer: Cigna of CA HMO |
$2,046.69
|
| Rate for Payer: Cigna of CA PPO |
$2,046.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,046.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,169.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1,169.54
|
| Rate for Payer: Galaxy Health WC |
$2,485.27
|
| Rate for Payer: Global Benefits Group Commercial |
$1,754.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,631.47
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,856.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,725.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$584.77
|
| Rate for Payer: Multiplan Commercial |
$2,192.89
|
| Rate for Payer: Networks By Design Commercial |
$1,461.92
|
| Rate for Payer: Prime Health Services Commercial |
$2,485.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,097.32
|
| Rate for Payer: United Healthcare All Other HMO |
$1,068.08
|
| Rate for Payer: United Healthcare HMO Rider |
$1,044.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$957.56
|
|
|
PALIPERIDONE PALMITATE 234 MG/1.5 ML INTRAMUSCULAR SYRINGE [108109]
|
Facility
|
OP
|
$2,923.85
|
|
|
Service Code
|
HCPCS J2426
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$12.57 |
| Max. Negotiated Rate |
$2,631.47 |
| Rate for Payer: Adventist Health Commercial |
$584.77
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$91.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$16.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15.69
|
| Rate for Payer: Blue Shield of California Commercial |
$19.62
|
| Rate for Payer: Blue Shield of California EPN |
$17.84
|
| Rate for Payer: Cash Price |
$1,315.73
|
| Rate for Payer: Cash Price |
$1,315.73
|
| Rate for Payer: Central Health Plan Commercial |
$2,339.08
|
| Rate for Payer: Cigna of CA HMO |
$2,046.69
|
| Rate for Payer: Cigna of CA PPO |
$2,046.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.97
|
| Rate for Payer: Dignity Health Medicare Advantage |
$16.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2,046.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.46
|
| Rate for Payer: EPIC Health Plan Senior |
$16.97
|
| Rate for Payer: Galaxy Health WC |
$2,485.27
|
| Rate for Payer: Global Benefits Group Commercial |
$1,754.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,631.47
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$25.31
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,856.64
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$584.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.68
|
| Rate for Payer: Multiplan Commercial |
$2,192.89
|
| Rate for Payer: Networks By Design Commercial |
$1,461.92
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.43
|
| Rate for Payer: Prime Health Services Commercial |
$2,485.27
|
| Rate for Payer: Prime Health Services Medicare |
$16.36
|
| Rate for Payer: Riverside University Health System MISP |
$16.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,754.31
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,754.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,097.32
|
| Rate for Payer: United Healthcare All Other HMO |
$1,068.08
|
| Rate for Payer: United Healthcare HMO Rider |
$1,044.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$957.56
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.43
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.97
|
| Rate for Payer: Vantage Medical Group Senior |
$16.97
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
|
Facility
|
IP
|
$4.32
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.86 |
| Max. Negotiated Rate |
$3.89 |
| Rate for Payer: Adventist Health Commercial |
$0.86
|
| Rate for Payer: Blue Shield of California Commercial |
$3.46
|
| Rate for Payer: Blue Shield of California EPN |
$2.18
|
| Rate for Payer: Cash Price |
$1.94
|
| Rate for Payer: Central Health Plan Commercial |
$3.46
|
| Rate for Payer: Cigna of CA HMO |
$3.02
|
| Rate for Payer: Cigna of CA PPO |
$3.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.73
|
| Rate for Payer: EPIC Health Plan Senior |
$1.73
|
| Rate for Payer: Galaxy Health WC |
$3.67
|
| Rate for Payer: Global Benefits Group Commercial |
$2.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.86
|
| Rate for Payer: Multiplan Commercial |
$3.24
|
| Rate for Payer: Networks By Design Commercial |
$2.16
|
| Rate for Payer: Prime Health Services Commercial |
$3.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.62
|
| Rate for Payer: United Healthcare All Other HMO |
$1.58
|
| Rate for Payer: United Healthcare HMO Rider |
$1.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.41
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
|
Facility
|
OP
|
$4.32
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.57 |
| Max. Negotiated Rate |
$70.11 |
| Rate for Payer: Adventist Health Commercial |
$0.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.24
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4.04
|
| Rate for Payer: Blue Shield of California EPN |
$3.67
|
| Rate for Payer: Cash Price |
$1.94
|
| Rate for Payer: Cash Price |
$1.94
|
| Rate for Payer: Central Health Plan Commercial |
$3.46
|
| Rate for Payer: Cigna of CA HMO |
$3.02
|
| Rate for Payer: Cigna of CA PPO |
$3.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.73
|
| Rate for Payer: EPIC Health Plan Senior |
$1.73
|
| Rate for Payer: Galaxy Health WC |
$3.67
|
| Rate for Payer: Global Benefits Group Commercial |
$2.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.02
|
| Rate for Payer: Multiplan Commercial |
$3.24
|
| Rate for Payer: Networks By Design Commercial |
$2.16
|
| Rate for Payer: Prime Health Services Commercial |
$3.67
|
| Rate for Payer: Riverside University Health System MISP |
$1.73
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.62
|
| Rate for Payer: United Healthcare All Other HMO |
$1.58
|
| Rate for Payer: United Healthcare HMO Rider |
$1.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.67
|
| Rate for Payer: Vantage Medical Group Senior |
$3.67
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION. [40836591]
|
Facility
|
OP
|
$12.00
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.57 |
| Max. Negotiated Rate |
$70.11 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4.04
|
| Rate for Payer: Blue Shield of California EPN |
$3.67
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Riverside University Health System MISP |
$4.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10.20
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION. [40836591]
|
Facility
|
IP
|
$12.00
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9.62
|
| Rate for Payer: Blue Shield of California EPN |
$6.05
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SYRINGE [222773]
|
Facility
|
IP
|
$12.00
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Blue Shield of California Commercial |
$9.62
|
| Rate for Payer: Blue Shield of California EPN |
$6.05
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SYRINGE [222773]
|
Facility
|
OP
|
$12.00
|
|
|
Service Code
|
HCPCS J2469
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.57 |
| Max. Negotiated Rate |
$70.11 |
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.11
|
| Rate for Payer: Blue Shield of California Commercial |
$4.04
|
| Rate for Payer: Blue Shield of California EPN |
$3.67
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Cash Price |
$5.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.57
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8.40
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Riverside University Health System MISP |
$4.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.20
|
| Rate for Payer: Vantage Medical Group Senior |
$10.20
|
|
|
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION [32589]
|
Facility
|
IP
|
$3.24
|
|
|
Service Code
|
HCPCS J2430
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$2.92 |
| Rate for Payer: Adventist Health Commercial |
$0.65
|
| Rate for Payer: Adventist Health Commercial |
$0.35
|
| Rate for Payer: Blue Shield of California Commercial |
$2.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1.39
|
| Rate for Payer: Blue Shield of California EPN |
$0.87
|
| Rate for Payer: Blue Shield of California EPN |
$1.63
|
| Rate for Payer: Cash Price |
$1.46
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Central Health Plan Commercial |
$2.59
|
| Rate for Payer: Central Health Plan Commercial |
$1.38
|
| Rate for Payer: Cigna of CA HMO |
$1.21
|
| Rate for Payer: Cigna of CA HMO |
$2.27
|
| Rate for Payer: Cigna of CA PPO |
$1.21
|
| Rate for Payer: Cigna of CA PPO |
$2.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.30
|
| Rate for Payer: EPIC Health Plan Senior |
$0.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1.30
|
| Rate for Payer: Galaxy Health WC |
$2.75
|
| Rate for Payer: Galaxy Health WC |
$1.47
|
| Rate for Payer: Global Benefits Group Commercial |
$1.04
|
| Rate for Payer: Global Benefits Group Commercial |
$1.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: Multiplan Commercial |
$1.30
|
| Rate for Payer: Multiplan Commercial |
$2.43
|
| Rate for Payer: Networks By Design Commercial |
$0.87
|
| Rate for Payer: Networks By Design Commercial |
$1.62
|
| Rate for Payer: Prime Health Services Commercial |
$2.75
|
| Rate for Payer: Prime Health Services Commercial |
$1.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.22
|
| Rate for Payer: United Healthcare All Other HMO |
$1.18
|
| Rate for Payer: United Healthcare All Other HMO |
$0.63
|
| Rate for Payer: United Healthcare HMO Rider |
$0.62
|
| Rate for Payer: United Healthcare HMO Rider |
$1.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.06
|
|
|
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION [32589]
|
Facility
|
OP
|
$1.73
|
|
|
Service Code
|
HCPCS J2430
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$609.57 |
| Rate for Payer: Adventist Health Commercial |
$0.35
|
| Rate for Payer: Adventist Health Commercial |
$0.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.32
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.43
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$488.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$488.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$609.57
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$609.57
|
| Rate for Payer: Blue Shield of California Commercial |
$27.07
|
| Rate for Payer: Blue Shield of California Commercial |
$27.07
|
| Rate for Payer: Blue Shield of California EPN |
$24.61
|
| Rate for Payer: Blue Shield of California EPN |
$24.61
|
| Rate for Payer: Cash Price |
$1.46
|
| Rate for Payer: Cash Price |
$1.46
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Central Health Plan Commercial |
$1.38
|
| Rate for Payer: Central Health Plan Commercial |
$2.59
|
| Rate for Payer: Cigna of CA HMO |
$1.21
|
| Rate for Payer: Cigna of CA HMO |
$2.27
|
| Rate for Payer: Cigna of CA PPO |
$2.27
|
| Rate for Payer: Cigna of CA PPO |
$1.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.75
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.30
|
| Rate for Payer: EPIC Health Plan Senior |
$0.69
|
| Rate for Payer: EPIC Health Plan Senior |
$1.30
|
| Rate for Payer: Galaxy Health WC |
$2.75
|
| Rate for Payer: Galaxy Health WC |
$1.47
|
| Rate for Payer: Global Benefits Group Commercial |
$1.04
|
| Rate for Payer: Global Benefits Group Commercial |
$1.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.92
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.10
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.02
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.27
|
| Rate for Payer: Multiplan Commercial |
$2.43
|
| Rate for Payer: Multiplan Commercial |
$1.30
|
| Rate for Payer: Networks By Design Commercial |
$1.62
|
| Rate for Payer: Networks By Design Commercial |
$0.87
|
| Rate for Payer: Prime Health Services Commercial |
$1.47
|
| Rate for Payer: Prime Health Services Commercial |
$2.75
|
| Rate for Payer: Riverside University Health System MISP |
$1.30
|
| Rate for Payer: Riverside University Health System MISP |
$0.69
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.22
|
| Rate for Payer: United Healthcare All Other HMO |
$1.18
|
| Rate for Payer: United Healthcare All Other HMO |
$0.63
|
| Rate for Payer: United Healthcare HMO Rider |
$0.62
|
| Rate for Payer: United Healthcare HMO Rider |
$1.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.75
|
| Rate for Payer: Vantage Medical Group Senior |
$2.75
|
| Rate for Payer: Vantage Medical Group Senior |
$1.47
|
|
|
PAMIDRONATE 30 MG INTRAVENOUS SOLUTION [10845]
|
Facility
|
OP
|
$22.55
|
|
|
Service Code
|
HCPCS J2430
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$609.57 |
| Rate for Payer: Adventist Health Commercial |
$4.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$488.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$609.57
|
| Rate for Payer: Blue Shield of California Commercial |
$27.07
|
| Rate for Payer: Blue Shield of California EPN |
$24.61
|
| Rate for Payer: Cash Price |
$10.15
|
| Rate for Payer: Cash Price |
$10.15
|
| Rate for Payer: Central Health Plan Commercial |
$18.04
|
| Rate for Payer: Cigna of CA HMO |
$15.79
|
| Rate for Payer: Cigna of CA PPO |
$15.79
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.17
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.02
|
| Rate for Payer: EPIC Health Plan Senior |
$9.02
|
| Rate for Payer: Galaxy Health WC |
$19.17
|
| Rate for Payer: Global Benefits Group Commercial |
$13.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.51
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.79
|
| Rate for Payer: Multiplan Commercial |
$16.91
|
| Rate for Payer: Networks By Design Commercial |
$11.28
|
| Rate for Payer: Prime Health Services Commercial |
$19.17
|
| Rate for Payer: Riverside University Health System MISP |
$9.02
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.53
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.46
|
| Rate for Payer: United Healthcare All Other HMO |
$8.24
|
| Rate for Payer: United Healthcare HMO Rider |
$8.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.39
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.17
|
| Rate for Payer: Vantage Medical Group Senior |
$19.17
|
|
|
PAMIDRONATE 30 MG INTRAVENOUS SOLUTION [10845]
|
Facility
|
IP
|
$22.55
|
|
|
Service Code
|
HCPCS J2430
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$20.30 |
| Rate for Payer: Adventist Health Commercial |
$4.51
|
| Rate for Payer: Blue Shield of California Commercial |
$18.09
|
| Rate for Payer: Blue Shield of California EPN |
$11.37
|
| Rate for Payer: Cash Price |
$10.15
|
| Rate for Payer: Central Health Plan Commercial |
$18.04
|
| Rate for Payer: Cigna of CA HMO |
$15.79
|
| Rate for Payer: Cigna of CA PPO |
$15.79
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.02
|
| Rate for Payer: EPIC Health Plan Senior |
$9.02
|
| Rate for Payer: Galaxy Health WC |
$19.17
|
| Rate for Payer: Global Benefits Group Commercial |
$13.53
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.32
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.51
|
| Rate for Payer: Multiplan Commercial |
$16.91
|
| Rate for Payer: Networks By Design Commercial |
$11.28
|
| Rate for Payer: Prime Health Services Commercial |
$19.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.46
|
| Rate for Payer: United Healthcare All Other HMO |
$8.24
|
| Rate for Payer: United Healthcare HMO Rider |
$8.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.39
|
|
|
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION [33886]
|
Facility
|
IP
|
$5.45
|
|
|
Service Code
|
HCPCS J2430
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.09 |
| Max. Negotiated Rate |
$4.91 |
| Rate for Payer: Adventist Health Commercial |
$1.09
|
| Rate for Payer: Blue Shield of California Commercial |
$4.37
|
| Rate for Payer: Blue Shield of California EPN |
$2.75
|
| Rate for Payer: Cash Price |
$2.45
|
| Rate for Payer: Central Health Plan Commercial |
$4.36
|
| Rate for Payer: Cigna of CA HMO |
$3.81
|
| Rate for Payer: Cigna of CA PPO |
$3.81
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.18
|
| Rate for Payer: EPIC Health Plan Senior |
$2.18
|
| Rate for Payer: Galaxy Health WC |
$4.63
|
| Rate for Payer: Global Benefits Group Commercial |
$3.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.91
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.09
|
| Rate for Payer: Multiplan Commercial |
$4.09
|
| Rate for Payer: Networks By Design Commercial |
$2.73
|
| Rate for Payer: Prime Health Services Commercial |
$4.63
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.05
|
| Rate for Payer: United Healthcare All Other HMO |
$1.99
|
| Rate for Payer: United Healthcare HMO Rider |
$1.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.78
|
|
|
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION [33886]
|
Facility
|
OP
|
$5.45
|
|
|
Service Code
|
HCPCS J2430
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.09 |
| Max. Negotiated Rate |
$609.57 |
| Rate for Payer: Adventist Health Commercial |
$1.09
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.09
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$488.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$609.57
|
| Rate for Payer: Blue Shield of California Commercial |
$27.07
|
| Rate for Payer: Blue Shield of California EPN |
$24.61
|
| Rate for Payer: Cash Price |
$2.45
|
| Rate for Payer: Cash Price |
$2.45
|
| Rate for Payer: Central Health Plan Commercial |
$4.36
|
| Rate for Payer: Cigna of CA HMO |
$3.81
|
| Rate for Payer: Cigna of CA PPO |
$3.81
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.63
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.63
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.63
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.18
|
| Rate for Payer: EPIC Health Plan Senior |
$2.18
|
| Rate for Payer: Galaxy Health WC |
$4.63
|
| Rate for Payer: Global Benefits Group Commercial |
$3.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12.03
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.09
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.81
|
| Rate for Payer: Multiplan Commercial |
$4.09
|
| Rate for Payer: Networks By Design Commercial |
$2.73
|
| Rate for Payer: Prime Health Services Commercial |
$4.63
|
| Rate for Payer: Riverside University Health System MISP |
$2.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.05
|
| Rate for Payer: United Healthcare All Other HMO |
$1.99
|
| Rate for Payer: United Healthcare HMO Rider |
$1.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.63
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.63
|
| Rate for Payer: Vantage Medical Group Senior |
$4.63
|
|
|
PAMIDRONATE 90 MG/10 ML (9 MG/ML) INTRAVENOUS SOLUTION [32855]
|
Facility
|
IP
|
$12.67
|
|
|
Service Code
|
HCPCS J2430
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$11.40 |
| Rate for Payer: Adventist Health Commercial |
$2.53
|
| Rate for Payer: Adventist Health Commercial |
$2.25
|
| Rate for Payer: Blue Shield of California Commercial |
$10.16
|
| Rate for Payer: Blue Shield of California Commercial |
$9.01
|
| Rate for Payer: Blue Shield of California EPN |
$5.66
|
| Rate for Payer: Blue Shield of California EPN |
$6.39
|
| Rate for Payer: Cash Price |
$5.70
|
| Rate for Payer: Cash Price |
$5.05
|
| Rate for Payer: Central Health Plan Commercial |
$10.14
|
| Rate for Payer: Central Health Plan Commercial |
$8.98
|
| Rate for Payer: Cigna of CA HMO |
$7.86
|
| Rate for Payer: Cigna of CA HMO |
$8.87
|
| Rate for Payer: Cigna of CA PPO |
$7.86
|
| Rate for Payer: Cigna of CA PPO |
$8.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.86
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$8.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.07
|
| Rate for Payer: EPIC Health Plan Senior |
$4.49
|
| Rate for Payer: EPIC Health Plan Senior |
$5.07
|
| Rate for Payer: Galaxy Health WC |
$10.77
|
| Rate for Payer: Galaxy Health WC |
$9.55
|
| Rate for Payer: Global Benefits Group Commercial |
$6.74
|
| Rate for Payer: Global Benefits Group Commercial |
$7.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.11
|
| Rate for Payer: Health Management Network EPO/PPO |
$11.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$8.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.63
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$7.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.25
|
| Rate for Payer: Multiplan Commercial |
$8.42
|
| Rate for Payer: Multiplan Commercial |
$9.50
|
| Rate for Payer: Networks By Design Commercial |
$5.62
|
| Rate for Payer: Networks By Design Commercial |
$6.33
|
| Rate for Payer: Prime Health Services Commercial |
$10.77
|
| Rate for Payer: Prime Health Services Commercial |
$9.55
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.76
|
| Rate for Payer: United Healthcare All Other HMO |
$4.63
|
| Rate for Payer: United Healthcare All Other HMO |
$4.10
|
| Rate for Payer: United Healthcare HMO Rider |
$4.01
|
| Rate for Payer: United Healthcare HMO Rider |
$4.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.15
|
|
