ALBUTEROL SULFATE 0.63 MG/3 ML SOLUTION FOR NEBULIZATION [31577]
|
Facility
IP
|
$0.53
|
|
Service Code
|
NDC 0487-0301-01
|
Hospital Charge Code |
NDG31577
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.11 |
Max. Negotiated Rate |
$0.48 |
Rate for Payer: Blue Shield of California Commercial |
$0.40
|
Rate for Payer: Blue Shield of California EPN |
$0.28
|
Rate for Payer: Cash Price |
$0.24
|
Rate for Payer: Central Health Plan Commercial |
$0.42
|
Rate for Payer: Cigna of CA HMO |
$0.37
|
Rate for Payer: Cigna of CA PPO |
$0.37
|
Rate for Payer: EPIC Health Plan Commercial |
$0.21
|
Rate for Payer: Galaxy Health WC |
$0.45
|
Rate for Payer: Global Benefits Group Commercial |
$0.32
|
Rate for Payer: Health Management Network EPO/PPO |
$0.48
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.35
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
Rate for Payer: Multiplan Commercial |
$0.40
|
Rate for Payer: Networks By Design Commercial |
$0.34
|
Rate for Payer: Prime Health Services Commercial |
$0.45
|
|
ALBUTEROL SULFATE 1.25 MG/3 ML SOLUTION FOR NEBULIZATION [31578]
|
Facility
OP
|
$0.53
|
|
Service Code
|
NDC 0487-9904-25
|
Hospital Charge Code |
NDG31578
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.11 |
Max. Negotiated Rate |
$0.48 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.32
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.45
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.29
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.29
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.26
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.31
|
Rate for Payer: BCBS Transplant Transplant |
$0.32
|
Rate for Payer: Blue Shield of California Commercial |
$0.33
|
Rate for Payer: Blue Shield of California EPN |
$0.26
|
Rate for Payer: Cash Price |
$0.24
|
Rate for Payer: Central Health Plan Commercial |
$0.42
|
Rate for Payer: Cigna of CA HMO |
$0.37
|
Rate for Payer: Cigna of CA PPO |
$0.37
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.45
|
Rate for Payer: EPIC Health Plan Commercial |
$0.21
|
Rate for Payer: EPIC Health Plan Transplant |
$0.21
|
Rate for Payer: Galaxy Health WC |
$0.45
|
Rate for Payer: Global Benefits Group Commercial |
$0.32
|
Rate for Payer: Health Management Network EPO/PPO |
$0.48
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.40
|
Rate for Payer: IEHP medi-cal |
$0.19
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.35
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
Rate for Payer: Multiplan Commercial |
$0.40
|
Rate for Payer: Networks By Design Commercial |
$0.34
|
Rate for Payer: Prime Health Services Commercial |
$0.45
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.32
|
Rate for Payer: Riverside University Health MISP |
$0.21
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.32
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.32
|
Rate for Payer: United Healthcare All Other Commercial |
$0.27
|
Rate for Payer: United Healthcare All Other HMO |
$0.27
|
Rate for Payer: United Healthcare HMO Rider |
$0.27
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.27
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.45
|
Rate for Payer: Vantage Medical Group Senior |
$0.45
|
|
ALBUTEROL SULFATE 1.25 MG/3 ML SOLUTION FOR NEBULIZATION [31578]
|
Facility
OP
|
$0.53
|
|
Service Code
|
NDC 0487-9904-01
|
Hospital Charge Code |
NDG31578
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.11 |
Max. Negotiated Rate |
$0.48 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.32
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.45
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.29
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.29
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.26
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.31
|
Rate for Payer: BCBS Transplant Transplant |
$0.32
|
Rate for Payer: Blue Shield of California Commercial |
$0.33
|
Rate for Payer: Blue Shield of California EPN |
$0.26
|
Rate for Payer: Cash Price |
$0.24
|
Rate for Payer: Central Health Plan Commercial |
$0.42
|
Rate for Payer: Cigna of CA HMO |
$0.37
|
Rate for Payer: Cigna of CA PPO |
$0.37
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.45
|
Rate for Payer: EPIC Health Plan Commercial |
$0.21
|
Rate for Payer: EPIC Health Plan Transplant |
$0.21
|
Rate for Payer: Galaxy Health WC |
$0.45
|
Rate for Payer: Global Benefits Group Commercial |
$0.32
|
Rate for Payer: Health Management Network EPO/PPO |
$0.48
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.40
|
Rate for Payer: IEHP medi-cal |
$0.19
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.35
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
Rate for Payer: Multiplan Commercial |
$0.40
|
Rate for Payer: Networks By Design Commercial |
$0.34
|
Rate for Payer: Prime Health Services Commercial |
$0.45
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.32
|
Rate for Payer: Riverside University Health MISP |
$0.21
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.32
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.32
|
Rate for Payer: United Healthcare All Other Commercial |
$0.27
|
Rate for Payer: United Healthcare All Other HMO |
$0.27
|
Rate for Payer: United Healthcare HMO Rider |
$0.27
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.27
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.45
|
Rate for Payer: Vantage Medical Group Senior |
$0.45
|
|
ALBUTEROL SULFATE 1.25 MG/3 ML SOLUTION FOR NEBULIZATION [31578]
|
Facility
IP
|
$0.53
|
|
Service Code
|
NDC 0487-9904-01
|
Hospital Charge Code |
NDG31578
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.11 |
Max. Negotiated Rate |
$0.48 |
Rate for Payer: Blue Shield of California Commercial |
$0.40
|
Rate for Payer: Blue Shield of California EPN |
$0.28
|
Rate for Payer: Cash Price |
$0.24
|
Rate for Payer: Central Health Plan Commercial |
$0.42
|
Rate for Payer: Cigna of CA HMO |
$0.37
|
Rate for Payer: Cigna of CA PPO |
$0.37
|
Rate for Payer: EPIC Health Plan Commercial |
$0.21
|
Rate for Payer: Galaxy Health WC |
$0.45
|
Rate for Payer: Global Benefits Group Commercial |
$0.32
|
Rate for Payer: Health Management Network EPO/PPO |
$0.48
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.35
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
Rate for Payer: Multiplan Commercial |
$0.40
|
Rate for Payer: Networks By Design Commercial |
$0.34
|
Rate for Payer: Prime Health Services Commercial |
$0.45
|
|
ALBUTEROL SULFATE 1.25 MG/3 ML SOLUTION FOR NEBULIZATION [31578]
|
Facility
IP
|
$0.53
|
|
Service Code
|
NDC 0487-9904-25
|
Hospital Charge Code |
NDG31578
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.11 |
Max. Negotiated Rate |
$0.48 |
Rate for Payer: Blue Shield of California Commercial |
$0.40
|
Rate for Payer: Blue Shield of California EPN |
$0.28
|
Rate for Payer: Cash Price |
$0.24
|
Rate for Payer: Central Health Plan Commercial |
$0.42
|
Rate for Payer: Cigna of CA HMO |
$0.37
|
Rate for Payer: Cigna of CA PPO |
$0.37
|
Rate for Payer: EPIC Health Plan Commercial |
$0.21
|
Rate for Payer: Galaxy Health WC |
$0.45
|
Rate for Payer: Global Benefits Group Commercial |
$0.32
|
Rate for Payer: Health Management Network EPO/PPO |
$0.48
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.35
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
Rate for Payer: Multiplan Commercial |
$0.40
|
Rate for Payer: Networks By Design Commercial |
$0.34
|
Rate for Payer: Prime Health Services Commercial |
$0.45
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
OP
|
$0.08
|
|
Service Code
|
NDC 76204-200-01
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.07 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.05
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.07
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.04
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.04
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.04
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.05
|
Rate for Payer: BCBS Transplant Transplant |
$0.05
|
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Central Health Plan Commercial |
$0.06
|
Rate for Payer: Cigna of CA HMO |
$0.06
|
Rate for Payer: Cigna of CA PPO |
$0.06
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.07
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: EPIC Health Plan Transplant |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.07
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Health Management Network EPO/PPO |
$0.07
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.06
|
Rate for Payer: IEHP medi-cal |
$0.03
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.07
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.05
|
Rate for Payer: Riverside University Health MISP |
$0.03
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.05
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.05
|
Rate for Payer: United Healthcare All Other Commercial |
$0.04
|
Rate for Payer: United Healthcare All Other HMO |
$0.04
|
Rate for Payer: United Healthcare HMO Rider |
$0.04
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.04
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.07
|
Rate for Payer: Vantage Medical Group Senior |
$0.07
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
OP
|
$0.06
|
|
Service Code
|
NDC 0378-8270-91
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.04
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.04
|
Rate for Payer: BCBS Transplant Transplant |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Central Health Plan Commercial |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Management Network EPO/PPO |
$0.05
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
Rate for Payer: IEHP medi-cal |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: Riverside University Health MISP |
$0.02
|
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 |
$0.03
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
Rate for Payer: Vantage Medical Group Senior |
$0.05
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
OP
|
$0.10
|
|
Service Code
|
NDC 76204-200-30
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.09 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.09
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.06
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.06
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.05
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.06
|
Rate for Payer: BCBS Transplant Transplant |
$0.06
|
Rate for Payer: Blue Shield of California Commercial |
$0.06
|
Rate for Payer: Blue Shield of California EPN |
$0.05
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Central Health Plan Commercial |
$0.08
|
Rate for Payer: Cigna of CA HMO |
$0.07
|
Rate for Payer: Cigna of CA PPO |
$0.07
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.09
|
Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
Rate for Payer: EPIC Health Plan Transplant |
$0.04
|
Rate for Payer: Galaxy Health WC |
$0.09
|
Rate for Payer: Global Benefits Group Commercial |
$0.06
|
Rate for Payer: Health Management Network EPO/PPO |
$0.09
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.08
|
Rate for Payer: IEHP medi-cal |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.07
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.08
|
Rate for Payer: Networks By Design Commercial |
$0.07
|
Rate for Payer: Prime Health Services Commercial |
$0.09
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.06
|
Rate for Payer: Riverside University Health MISP |
$0.04
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.06
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.06
|
Rate for Payer: United Healthcare All Other Commercial |
$0.05
|
Rate for Payer: United Healthcare All Other HMO |
$0.05
|
Rate for Payer: United Healthcare HMO Rider |
$0.05
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.05
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.09
|
Rate for Payer: Vantage Medical Group Senior |
$0.09
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
IP
|
$0.06
|
|
Service Code
|
NDC 0378-8270-91
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Central Health Plan Commercial |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Management Network EPO/PPO |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
IP
|
$0.08
|
|
Service Code
|
NDC 0378-8270-93
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.07 |
Rate for Payer: Blue Shield of California Commercial |
$0.06
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Central Health Plan Commercial |
$0.06
|
Rate for Payer: Cigna of CA HMO |
$0.06
|
Rate for Payer: Cigna of CA PPO |
$0.06
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.07
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Health Management Network EPO/PPO |
$0.07
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.07
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
OP
|
$0.06
|
|
Service Code
|
NDC 0378-8270-62
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.04
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.04
|
Rate for Payer: BCBS Transplant Transplant |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Central Health Plan Commercial |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Management Network EPO/PPO |
$0.05
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
Rate for Payer: IEHP medi-cal |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: Riverside University Health MISP |
$0.02
|
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 |
$0.03
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
Rate for Payer: Vantage Medical Group Senior |
$0.05
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
OP
|
$0.06
|
|
Service Code
|
NDC 0487-9501-03
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.04
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.04
|
Rate for Payer: BCBS Transplant Transplant |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Central Health Plan Commercial |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Management Network EPO/PPO |
$0.05
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
Rate for Payer: IEHP medi-cal |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: Riverside University Health MISP |
$0.02
|
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 |
$0.03
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
Rate for Payer: Vantage Medical Group Senior |
$0.05
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
OP
|
$0.06
|
|
Service Code
|
NDC 0487-9501-25
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.04
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.04
|
Rate for Payer: BCBS Transplant Transplant |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Central Health Plan Commercial |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Management Network EPO/PPO |
$0.05
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
Rate for Payer: IEHP medi-cal |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: Riverside University Health MISP |
$0.02
|
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 |
$0.03
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
Rate for Payer: Vantage Medical Group Senior |
$0.05
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
IP
|
$0.10
|
|
Service Code
|
NDC 76204-200-60
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.09 |
Rate for Payer: Blue Shield of California Commercial |
$0.08
|
Rate for Payer: Blue Shield of California EPN |
$0.05
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Central Health Plan Commercial |
$0.08
|
Rate for Payer: Cigna of CA HMO |
$0.07
|
Rate for Payer: Cigna of CA PPO |
$0.07
|
Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
Rate for Payer: Galaxy Health WC |
$0.09
|
Rate for Payer: Global Benefits Group Commercial |
$0.06
|
Rate for Payer: Health Management Network EPO/PPO |
$0.09
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.07
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.08
|
Rate for Payer: Networks By Design Commercial |
$0.07
|
Rate for Payer: Prime Health Services Commercial |
$0.09
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
IP
|
$0.12
|
|
Service Code
|
NDC 0487-9501-01
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.11 |
Rate for Payer: Blue Shield of California Commercial |
$0.09
|
Rate for Payer: Blue Shield of California EPN |
$0.06
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Central Health Plan Commercial |
$0.10
|
Rate for Payer: Cigna of CA HMO |
$0.08
|
Rate for Payer: Cigna of CA PPO |
$0.08
|
Rate for Payer: EPIC Health Plan Commercial |
$0.05
|
Rate for Payer: Galaxy Health WC |
$0.10
|
Rate for Payer: Global Benefits Group Commercial |
$0.07
|
Rate for Payer: Health Management Network EPO/PPO |
$0.11
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.09
|
Rate for Payer: Networks By Design Commercial |
$0.08
|
Rate for Payer: Prime Health Services Commercial |
$0.10
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
OP
|
$0.10
|
|
Service Code
|
NDC 76204-200-60
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.09 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.09
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.06
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.06
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.05
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.06
|
Rate for Payer: BCBS Transplant Transplant |
$0.06
|
Rate for Payer: Blue Shield of California Commercial |
$0.06
|
Rate for Payer: Blue Shield of California EPN |
$0.05
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Central Health Plan Commercial |
$0.08
|
Rate for Payer: Cigna of CA HMO |
$0.07
|
Rate for Payer: Cigna of CA PPO |
$0.07
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.09
|
Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
Rate for Payer: EPIC Health Plan Transplant |
$0.04
|
Rate for Payer: Galaxy Health WC |
$0.09
|
Rate for Payer: Global Benefits Group Commercial |
$0.06
|
Rate for Payer: Health Management Network EPO/PPO |
$0.09
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.08
|
Rate for Payer: IEHP medi-cal |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.07
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.08
|
Rate for Payer: Networks By Design Commercial |
$0.07
|
Rate for Payer: Prime Health Services Commercial |
$0.09
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.06
|
Rate for Payer: Riverside University Health MISP |
$0.04
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.06
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.06
|
Rate for Payer: United Healthcare All Other Commercial |
$0.05
|
Rate for Payer: United Healthcare All Other HMO |
$0.05
|
Rate for Payer: United Healthcare HMO Rider |
$0.05
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.05
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.09
|
Rate for Payer: Vantage Medical Group Senior |
$0.09
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
OP
|
$0.08
|
|
Service Code
|
NDC 0378-8270-93
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.07 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.05
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.07
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.04
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.04
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.04
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.05
|
Rate for Payer: BCBS Transplant Transplant |
$0.05
|
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$0.04
|
Rate for Payer: Cash Price |
$0.04
|
Rate for Payer: Central Health Plan Commercial |
$0.06
|
Rate for Payer: Cigna of CA HMO |
$0.06
|
Rate for Payer: Cigna of CA PPO |
$0.06
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.07
|
Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
Rate for Payer: EPIC Health Plan Transplant |
$0.03
|
Rate for Payer: Galaxy Health WC |
$0.07
|
Rate for Payer: Global Benefits Group Commercial |
$0.05
|
Rate for Payer: Health Management Network EPO/PPO |
$0.07
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.06
|
Rate for Payer: IEHP medi-cal |
$0.03
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.05
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.06
|
Rate for Payer: Networks By Design Commercial |
$0.05
|
Rate for Payer: Prime Health Services Commercial |
$0.07
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.05
|
Rate for Payer: Riverside University Health MISP |
$0.03
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.05
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.05
|
Rate for Payer: United Healthcare All Other Commercial |
$0.04
|
Rate for Payer: United Healthcare All Other HMO |
$0.04
|
Rate for Payer: United Healthcare HMO Rider |
$0.04
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.04
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.07
|
Rate for Payer: Vantage Medical Group Senior |
$0.07
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
IP
|
$0.06
|
|
Service Code
|
NDC 0487-9501-03
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Central Health Plan Commercial |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Management Network EPO/PPO |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
IP
|
$0.06
|
|
Service Code
|
NDC 0487-9501-25
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Central Health Plan Commercial |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Management Network EPO/PPO |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
OP
|
$0.06
|
|
Service Code
|
NDC 0378-8270-64
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.04
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.05
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.03
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.03
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.04
|
Rate for Payer: BCBS Transplant Transplant |
$0.04
|
Rate for Payer: Blue Shield of California Commercial |
$0.04
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Central Health Plan Commercial |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: EPIC Health Plan Transplant |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Management Network EPO/PPO |
$0.05
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.05
|
Rate for Payer: IEHP medi-cal |
$0.02
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.04
|
Rate for Payer: Riverside University Health MISP |
$0.02
|
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 |
$0.03
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
Rate for Payer: Vantage Medical Group Senior |
$0.05
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
IP
|
$0.06
|
|
Service Code
|
NDC 0378-8270-64
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Central Health Plan Commercial |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Management Network EPO/PPO |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
OP
|
$0.12
|
|
Service Code
|
NDC 0487-9501-01
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.11 |
Rate for Payer: Aetna of CA HMO/PPO |
$0.07
|
Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.10
|
Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.07
|
Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.07
|
Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.06
|
Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.07
|
Rate for Payer: BCBS Transplant Transplant |
$0.07
|
Rate for Payer: Blue Shield of California Commercial |
$0.08
|
Rate for Payer: Blue Shield of California EPN |
$0.06
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Central Health Plan Commercial |
$0.10
|
Rate for Payer: Cigna of CA HMO |
$0.08
|
Rate for Payer: Cigna of CA PPO |
$0.08
|
Rate for Payer: Dignity Health Commercial/Exchange |
$0.10
|
Rate for Payer: EPIC Health Plan Commercial |
$0.05
|
Rate for Payer: EPIC Health Plan Transplant |
$0.05
|
Rate for Payer: Galaxy Health WC |
$0.10
|
Rate for Payer: Global Benefits Group Commercial |
$0.07
|
Rate for Payer: Health Management Network EPO/PPO |
$0.11
|
Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.09
|
Rate for Payer: IEHP medi-cal |
$0.04
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.08
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.09
|
Rate for Payer: Networks By Design Commercial |
$0.08
|
Rate for Payer: Prime Health Services Commercial |
$0.10
|
Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.07
|
Rate for Payer: Riverside University Health MISP |
$0.05
|
Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.07
|
Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.07
|
Rate for Payer: United Healthcare All Other Commercial |
$0.06
|
Rate for Payer: United Healthcare All Other HMO |
$0.06
|
Rate for Payer: United Healthcare HMO Rider |
$0.06
|
Rate for Payer: United Healthcare Select/Navigate/Core |
$0.06
|
Rate for Payer: Vantage Medical Group Medi-Cal |
$0.10
|
Rate for Payer: Vantage Medical Group Senior |
$0.10
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
IP
|
$0.06
|
|
Service Code
|
NDC 0378-8270-62
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.01 |
Max. Negotiated Rate |
$0.05 |
Rate for Payer: Blue Shield of California Commercial |
$0.05
|
Rate for Payer: Blue Shield of California EPN |
$0.03
|
Rate for Payer: Cash Price |
$0.03
|
Rate for Payer: Central Health Plan Commercial |
$0.05
|
Rate for Payer: Cigna of CA HMO |
$0.04
|
Rate for Payer: Cigna of CA PPO |
$0.04
|
Rate for Payer: EPIC Health Plan Commercial |
$0.02
|
Rate for Payer: Galaxy Health WC |
$0.05
|
Rate for Payer: Global Benefits Group Commercial |
$0.04
|
Rate for Payer: Health Management Network EPO/PPO |
$0.05
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.04
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
Rate for Payer: Multiplan Commercial |
$0.05
|
Rate for Payer: Networks By Design Commercial |
$0.04
|
Rate for Payer: Prime Health Services Commercial |
$0.05
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
IP
|
$0.10
|
|
Service Code
|
NDC 76204-200-25
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.09 |
Rate for Payer: Blue Shield of California Commercial |
$0.08
|
Rate for Payer: Blue Shield of California EPN |
$0.05
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Central Health Plan Commercial |
$0.08
|
Rate for Payer: Cigna of CA HMO |
$0.07
|
Rate for Payer: Cigna of CA PPO |
$0.07
|
Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
Rate for Payer: Galaxy Health WC |
$0.09
|
Rate for Payer: Global Benefits Group Commercial |
$0.06
|
Rate for Payer: Health Management Network EPO/PPO |
$0.09
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.07
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.08
|
Rate for Payer: Networks By Design Commercial |
$0.07
|
Rate for Payer: Prime Health Services Commercial |
$0.09
|
|
ALBUTEROL SULFATE 2.5 MG/3 ML (0.083 %) SOLUTION FOR NEBULIZATION [250]
|
Facility
IP
|
$0.10
|
|
Service Code
|
NDC 76204-200-30
|
Hospital Charge Code |
1781155
|
Hospital Revenue Code
|
259
|
Min. Negotiated Rate |
$0.02 |
Max. Negotiated Rate |
$0.09 |
Rate for Payer: Blue Shield of California Commercial |
$0.08
|
Rate for Payer: Blue Shield of California EPN |
$0.05
|
Rate for Payer: Cash Price |
$0.05
|
Rate for Payer: Central Health Plan Commercial |
$0.08
|
Rate for Payer: Cigna of CA HMO |
$0.07
|
Rate for Payer: Cigna of CA PPO |
$0.07
|
Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
Rate for Payer: Galaxy Health WC |
$0.09
|
Rate for Payer: Global Benefits Group Commercial |
$0.06
|
Rate for Payer: Health Management Network EPO/PPO |
$0.09
|
Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.07
|
Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
Rate for Payer: Multiplan Commercial |
$0.08
|
Rate for Payer: Networks By Design Commercial |
$0.07
|
Rate for Payer: Prime Health Services Commercial |
$0.09
|
|