|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00983ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 009800Z
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00980ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 009830Z
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00B84ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00984ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00B83ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00B80ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00C83ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00884ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00C84ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00883ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
Pallidotomy ICD
|
Facility
IP
|
$12,866.00
|
|
|
Service Code
|
ICD 00C80ZZ
|
| Min. Negotiated Rate |
$10,000.00 |
| Max. Negotiated Rate |
$12,866.00 |
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,866.00
|
| Rate for Payer: Networks By Design Commercial |
$10,000.00
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
|
Facility
IP
|
$24.00
|
|
|
Service Code
|
CPT J2469
|
| Hospital Charge Code |
1720944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.80 |
| Max. Negotiated Rate |
$21.60 |
| Rate for Payer: Blue Shield of California Commercial |
$18.00
|
| Rate for Payer: Blue Shield of California Commercial |
$6.30
|
| Rate for Payer: Blue Shield of California EPN |
$12.82
|
| Rate for Payer: Blue Shield of California EPN |
$4.49
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$3.78
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Central Health Plan Commercial |
$6.72
|
| Rate for Payer: Cigna of CA HMO |
$16.80
|
| Rate for Payer: Cigna of CA HMO |
$5.88
|
| Rate for Payer: Cigna of CA PPO |
$5.88
|
| Rate for Payer: Cigna of CA PPO |
$16.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$7.14
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$6.30
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$4.20
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Prime Health Services Commercial |
$7.14
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION [36591]
|
Facility
OP
|
$24.00
|
|
|
Service Code
|
CPT J2469
|
| Hospital Charge Code |
1720944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$61.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.14
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.40
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.62
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$13.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$4.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.52
|
| Rate for Payer: BCBS Transplant Transplant |
$5.04
|
| Rate for Payer: BCBS Transplant Transplant |
$14.40
|
| Rate for Payer: Blue Shield of California Commercial |
$17.82
|
| Rate for Payer: Blue Shield of California Commercial |
$17.82
|
| Rate for Payer: Blue Shield of California EPN |
$16.20
|
| Rate for Payer: Blue Shield of California EPN |
$16.20
|
| Rate for Payer: Cash Price |
$3.78
|
| Rate for Payer: Cash Price |
$3.78
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Cash Price |
$10.80
|
| Rate for Payer: Central Health Plan Commercial |
$6.72
|
| Rate for Payer: Central Health Plan Commercial |
$19.20
|
| Rate for Payer: Cigna of CA HMO |
$5.88
|
| Rate for Payer: Cigna of CA HMO |
$16.80
|
| Rate for Payer: Cigna of CA PPO |
$16.80
|
| Rate for Payer: Cigna of CA PPO |
$5.88
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$3.36
|
| Rate for Payer: EPIC Health Plan Transplant |
$9.60
|
| Rate for Payer: Galaxy Health WC |
$20.40
|
| Rate for Payer: Galaxy Health WC |
$7.14
|
| Rate for Payer: Global Benefits Group Commercial |
$14.40
|
| Rate for Payer: Global Benefits Group Commercial |
$5.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.56
|
| Rate for Payer: Health Management Network EPO/PPO |
$21.60
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$18.00
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$6.30
|
| Rate for Payer: IEHP medi-cal |
$0.98
|
| Rate for Payer: IEHP medi-cal |
$0.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$16.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.80
|
| Rate for Payer: Multiplan Commercial |
$18.00
|
| Rate for Payer: Multiplan Commercial |
$6.30
|
| Rate for Payer: Networks By Design Commercial |
$12.00
|
| Rate for Payer: Networks By Design Commercial |
$4.20
|
| Rate for Payer: Prime Health Services Commercial |
$20.40
|
| Rate for Payer: Prime Health Services Commercial |
$7.14
|
| Rate for Payer: Riverside University Health MISP |
$3.36
|
| Rate for Payer: Riverside University Health MISP |
$9.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$14.40
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$12.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.20
|
| Rate for Payer: United Healthcare All Other HMO |
$12.00
|
| Rate for Payer: United Healthcare All Other HMO |
$4.20
|
| Rate for Payer: United Healthcare HMO Rider |
$12.00
|
| Rate for Payer: United Healthcare HMO Rider |
$4.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$12.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.40
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.14
|
| Rate for Payer: Vantage Medical Group Senior |
$20.40
|
| Rate for Payer: Vantage Medical Group Senior |
$7.14
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SOLUTION. [40836591]
|
Facility
OP
|
$12.00
|
|
|
Service Code
|
CPT J2469
|
| Hospital Charge Code |
1720944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$61.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.52
|
| Rate for Payer: BCBS Transplant Transplant |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$17.82
|
| Rate for Payer: Blue Shield of California EPN |
$16.20
|
| 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: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$9.00
|
| Rate for Payer: IEHP medi-cal |
$0.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| 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: Riverside University Health 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 |
$6.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.00
|
| 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
|
CPT J2469
|
| Hospital Charge Code |
1720944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Blue Shield of California Commercial |
$9.00
|
| Rate for Payer: Blue Shield of California EPN |
$6.41
|
| 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: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$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 Permanente of CA Commercial/Self Funded |
$8.00
|
| 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
|
|
|
PALONOSETRON 0.25 MG/5 ML INTRAVENOUS SYRINGE [222773]
|
Facility
OP
|
$12.00
|
|
|
Service Code
|
CPT J2469
|
| Hospital Charge Code |
1720944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.98 |
| Max. Negotiated Rate |
$61.52 |
| Rate for Payer: Aetna of CA HMO/PPO |
$5.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.18
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$61.52
|
| Rate for Payer: BCBS Transplant Transplant |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$17.82
|
| Rate for Payer: Blue Shield of California EPN |
$16.20
|
| 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: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$9.00
|
| Rate for Payer: IEHP medi-cal |
$0.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| 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: Riverside University Health 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 |
$6.00
|
| Rate for Payer: United Healthcare All Other HMO |
$6.00
|
| Rate for Payer: United Healthcare HMO Rider |
$6.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.00
|
| 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 SYRINGE [222773]
|
Facility
IP
|
$12.00
|
|
|
Service Code
|
CPT J2469
|
| Hospital Charge Code |
1720944
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.40 |
| Max. Negotiated Rate |
$10.80 |
| Rate for Payer: Blue Shield of California Commercial |
$9.00
|
| Rate for Payer: Blue Shield of California EPN |
$6.41
|
| 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: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Transplant |
$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 Permanente of CA Commercial/Self Funded |
$8.00
|
| 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
|
|
|
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION [32589]
|
Facility
IP
|
$3.24
|
|
|
Service Code
|
CPT J2430
|
| Hospital Charge Code |
NDG32589
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.65 |
| Max. Negotiated Rate |
$2.92 |
| Rate for Payer: Blue Shield of California Commercial |
$2.43
|
| Rate for Payer: Blue Shield of California Commercial |
$1.26
|
| Rate for Payer: Blue Shield of California EPN |
$1.73
|
| Rate for Payer: Blue Shield of California EPN |
$0.90
|
| Rate for Payer: Cash Price |
$0.76
|
| Rate for Payer: Cash Price |
$1.46
|
| Rate for Payer: Central Health Plan Commercial |
$1.34
|
| Rate for Payer: Central Health Plan Commercial |
$2.59
|
| Rate for Payer: Cigna of CA HMO |
$1.18
|
| 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 |
$1.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.30
|
| Rate for Payer: Galaxy Health WC |
$2.75
|
| Rate for Payer: Galaxy Health WC |
$1.43
|
| Rate for Payer: Global Benefits Group Commercial |
$1.01
|
| Rate for Payer: Global Benefits Group Commercial |
$1.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.65
|
| Rate for Payer: Multiplan Commercial |
$2.43
|
| Rate for Payer: Multiplan Commercial |
$1.26
|
| Rate for Payer: Networks By Design Commercial |
$0.84
|
| Rate for Payer: Networks By Design Commercial |
$1.62
|
| Rate for Payer: Prime Health Services Commercial |
$1.43
|
| Rate for Payer: Prime Health Services Commercial |
$2.75
|
|
|
PAMIDRONATE 30 MG/10 ML (3 MG/ML) INTRAVENOUS SOLUTION [32589]
|
Facility
OP
|
$1.68
|
|
|
Service Code
|
CPT J2430
|
| Hospital Charge Code |
NDG32589
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$534.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.43
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$2.75
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.78
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.92
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.78
|
| 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 |
$534.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$534.83
|
| Rate for Payer: BCBS Transplant Transplant |
$1.01
|
| Rate for Payer: BCBS Transplant Transplant |
$1.94
|
| Rate for Payer: Blue Shield of California Commercial |
$24.81
|
| Rate for Payer: Blue Shield of California Commercial |
$24.81
|
| Rate for Payer: Blue Shield of California EPN |
$22.55
|
| Rate for Payer: Blue Shield of California EPN |
$22.55
|
| Rate for Payer: Cash Price |
$1.46
|
| Rate for Payer: Cash Price |
$0.76
|
| Rate for Payer: Cash Price |
$0.76
|
| Rate for Payer: Cash Price |
$1.46
|
| Rate for Payer: Central Health Plan Commercial |
$2.59
|
| Rate for Payer: Central Health Plan Commercial |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$2.27
|
| Rate for Payer: Cigna of CA HMO |
$1.18
|
| Rate for Payer: Cigna of CA PPO |
$2.27
|
| Rate for Payer: Cigna of CA PPO |
$1.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.67
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.30
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.67
|
| Rate for Payer: Galaxy Health WC |
$1.43
|
| Rate for Payer: Galaxy Health WC |
$2.75
|
| Rate for Payer: Global Benefits Group Commercial |
$1.01
|
| Rate for Payer: Global Benefits Group Commercial |
$1.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.51
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.92
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$2.43
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.26
|
| Rate for Payer: IEHP medi-cal |
$11.67
|
| Rate for Payer: IEHP medi-cal |
$11.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: Multiplan Commercial |
$1.26
|
| Rate for Payer: Multiplan Commercial |
$2.43
|
| Rate for Payer: Networks By Design Commercial |
$0.84
|
| 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 |
$1.43
|
| Rate for Payer: Riverside University Health MISP |
$1.30
|
| Rate for Payer: Riverside University Health MISP |
$0.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.62
|
| Rate for Payer: United Healthcare All Other HMO |
$1.62
|
| Rate for Payer: United Healthcare All Other HMO |
$0.84
|
| Rate for Payer: United Healthcare HMO Rider |
$1.62
|
| Rate for Payer: United Healthcare HMO Rider |
$0.84
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.43
|
| Rate for Payer: Vantage Medical Group Senior |
$1.43
|
| Rate for Payer: Vantage Medical Group Senior |
$2.75
|
|
|
PAMIDRONATE 30 MG INTRAVENOUS SOLUTION [10845]
|
Facility
IP
|
$22.55
|
|
|
Service Code
|
CPT J2430
|
| Hospital Charge Code |
1759468
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$20.30 |
| Rate for Payer: Blue Shield of California Commercial |
$16.91
|
| Rate for Payer: Blue Shield of California EPN |
$12.04
|
| Rate for Payer: Cash Price |
$10.15
|
| Rate for Payer: Central Health Plan Commercial |
$18.04
|
| Rate for Payer: Cigna of CA HMO |
$15.78
|
| Rate for Payer: Cigna of CA PPO |
$15.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$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 Permanente of CA Commercial/Self Funded |
$15.04
|
| 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
|
|
|
PAMIDRONATE 30 MG INTRAVENOUS SOLUTION [10845]
|
Facility
OP
|
$22.55
|
|
|
Service Code
|
CPT J2430
|
| Hospital Charge Code |
1759468
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.51 |
| Max. Negotiated Rate |
$534.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$19.17
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$12.40
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.40
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$488.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$534.83
|
| Rate for Payer: BCBS Transplant Transplant |
$13.53
|
| Rate for Payer: Blue Shield of California Commercial |
$24.81
|
| Rate for Payer: Blue Shield of California EPN |
$22.55
|
| 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 |
$15.78
|
| Rate for Payer: Cigna of CA PPO |
$15.78
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.02
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$16.91
|
| Rate for Payer: IEHP medi-cal |
$11.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$15.04
|
| 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: Riverside University Health 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 |
$11.28
|
| Rate for Payer: United Healthcare All Other HMO |
$11.28
|
| Rate for Payer: United Healthcare HMO Rider |
$11.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.17
|
| Rate for Payer: Vantage Medical Group Senior |
$19.17
|
|
|
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION [33886]
|
Facility
OP
|
$4.09
|
|
|
Service Code
|
CPT J2430
|
| Hospital Charge Code |
1755744
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$534.83 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17.47
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.25
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$488.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$534.83
|
| Rate for Payer: BCBS Transplant Transplant |
$2.45
|
| Rate for Payer: Blue Shield of California Commercial |
$24.81
|
| Rate for Payer: Blue Shield of California EPN |
$22.55
|
| Rate for Payer: Cash Price |
$1.84
|
| Rate for Payer: Cash Price |
$1.84
|
| Rate for Payer: Central Health Plan Commercial |
$3.27
|
| Rate for Payer: Cigna of CA HMO |
$2.86
|
| Rate for Payer: Cigna of CA PPO |
$2.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.64
|
| Rate for Payer: Galaxy Health WC |
$3.48
|
| Rate for Payer: Global Benefits Group Commercial |
$2.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.68
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.07
|
| Rate for Payer: IEHP medi-cal |
$11.67
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.82
|
| Rate for Payer: Multiplan Commercial |
$3.07
|
| Rate for Payer: Networks By Design Commercial |
$2.04
|
| Rate for Payer: Prime Health Services Commercial |
$3.48
|
| Rate for Payer: Riverside University Health MISP |
$1.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.45
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.04
|
| Rate for Payer: United Healthcare All Other HMO |
$2.04
|
| Rate for Payer: United Healthcare HMO Rider |
$2.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.48
|
| Rate for Payer: Vantage Medical Group Senior |
$3.48
|
|
|
PAMIDRONATE 60 MG/10 ML (6 MG/ML) INTRAVENOUS SOLUTION [33886]
|
Facility
IP
|
$4.09
|
|
|
Service Code
|
CPT J2430
|
| Hospital Charge Code |
1755744
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.82 |
| Max. Negotiated Rate |
$3.68 |
| Rate for Payer: Blue Shield of California Commercial |
$3.07
|
| Rate for Payer: Blue Shield of California EPN |
$2.18
|
| Rate for Payer: Cash Price |
$1.84
|
| Rate for Payer: Central Health Plan Commercial |
$3.27
|
| Rate for Payer: Cigna of CA HMO |
$2.86
|
| Rate for Payer: Cigna of CA PPO |
$2.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.64
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.64
|
| Rate for Payer: Galaxy Health WC |
$3.48
|
| Rate for Payer: Global Benefits Group Commercial |
$2.45
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.82
|
| Rate for Payer: Multiplan Commercial |
$3.07
|
| Rate for Payer: Networks By Design Commercial |
$2.04
|
| Rate for Payer: Prime Health Services Commercial |
$3.48
|
|
