|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
IP
|
$18.23
|
|
|
Service Code
|
NDC 0004-0800-85
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$16.41 |
| Rate for Payer: Adventist Health Commercial |
$3.65
|
| Rate for Payer: Blue Shield of California Commercial |
$14.09
|
| Rate for Payer: Blue Shield of California EPN |
$9.19
|
| Rate for Payer: Cash Price |
$10.02
|
| Rate for Payer: Central Health Plan Commercial |
$14.58
|
| Rate for Payer: Cigna of CA HMO |
$12.76
|
| Rate for Payer: Cigna of CA PPO |
$12.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.29
|
| Rate for Payer: EPIC Health Plan Senior |
$7.29
|
| Rate for Payer: Galaxy Health WC |
$15.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.65
|
| Rate for Payer: Multiplan Commercial |
$13.67
|
| Rate for Payer: Networks By Design Commercial |
$11.85
|
| Rate for Payer: Prime Health Services Commercial |
$15.50
|
|
|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
OP
|
$2.22
|
|
|
Service Code
|
NDC 64380-799-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Adventist Health Commercial |
$0.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.30
|
| Rate for Payer: Blue Shield of California Commercial |
$1.36
|
| Rate for Payer: Blue Shield of California EPN |
$0.89
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: Central Health Plan Commercial |
$1.78
|
| Rate for Payer: Cigna of CA HMO |
$1.55
|
| Rate for Payer: Cigna of CA PPO |
$1.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.89
|
| Rate for Payer: EPIC Health Plan Senior |
$0.89
|
| Rate for Payer: Galaxy Health WC |
$1.89
|
| Rate for Payer: Global Benefits Group Commercial |
$1.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.55
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Networks By Design Commercial |
$1.44
|
| Rate for Payer: Prime Health Services Commercial |
$1.89
|
| Rate for Payer: Riverside University Health System MISP |
$0.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.89
|
| Rate for Payer: Vantage Medical Group Senior |
$1.89
|
|
|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
OP
|
$3.00
|
|
|
Service Code
|
NDC 33342-258-66
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$2.70 |
| Rate for Payer: Adventist Health Commercial |
$0.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.55
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.76
|
| Rate for Payer: Blue Shield of California Commercial |
$1.83
|
| Rate for Payer: Blue Shield of California EPN |
$1.20
|
| Rate for Payer: Cash Price |
$1.65
|
| Rate for Payer: Central Health Plan Commercial |
$2.40
|
| Rate for Payer: Cigna of CA HMO |
$2.10
|
| Rate for Payer: Cigna of CA PPO |
$2.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.55
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.55
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1.20
|
| Rate for Payer: Galaxy Health WC |
$2.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.70
|
| Rate for Payer: InnovAge PACE Commercial |
$1.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.10
|
| Rate for Payer: Multiplan Commercial |
$2.25
|
| Rate for Payer: Networks By Design Commercial |
$1.95
|
| Rate for Payer: Prime Health Services Commercial |
$2.55
|
| Rate for Payer: Riverside University Health System MISP |
$1.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1.50
|
| Rate for Payer: United Healthcare HMO Rider |
$1.50
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.55
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.55
|
| Rate for Payer: Vantage Medical Group Senior |
$2.55
|
|
|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
IP
|
$3.00
|
|
|
Service Code
|
NDC 33342-258-66
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$2.70 |
| Rate for Payer: Adventist Health Commercial |
$0.60
|
| Rate for Payer: Blue Shield of California Commercial |
$2.32
|
| Rate for Payer: Blue Shield of California EPN |
$1.51
|
| Rate for Payer: Cash Price |
$1.65
|
| Rate for Payer: Central Health Plan Commercial |
$2.40
|
| Rate for Payer: Cigna of CA HMO |
$2.10
|
| Rate for Payer: Cigna of CA PPO |
$2.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.20
|
| Rate for Payer: EPIC Health Plan Senior |
$1.20
|
| Rate for Payer: Galaxy Health WC |
$2.55
|
| Rate for Payer: Global Benefits Group Commercial |
$1.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.60
|
| Rate for Payer: Multiplan Commercial |
$2.25
|
| Rate for Payer: Networks By Design Commercial |
$1.95
|
| Rate for Payer: Prime Health Services Commercial |
$2.55
|
|
|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
IP
|
$3.12
|
|
|
Service Code
|
NDC 31722-632-31
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$2.81 |
| Rate for Payer: Adventist Health Commercial |
$0.62
|
| Rate for Payer: Blue Shield of California Commercial |
$2.41
|
| Rate for Payer: Blue Shield of California EPN |
$1.57
|
| Rate for Payer: Cash Price |
$1.72
|
| Rate for Payer: Central Health Plan Commercial |
$2.50
|
| Rate for Payer: Cigna of CA HMO |
$2.18
|
| Rate for Payer: Cigna of CA PPO |
$2.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.25
|
| Rate for Payer: EPIC Health Plan Senior |
$1.25
|
| Rate for Payer: Galaxy Health WC |
$2.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.81
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.62
|
| Rate for Payer: Multiplan Commercial |
$2.34
|
| Rate for Payer: Networks By Design Commercial |
$2.03
|
| Rate for Payer: Prime Health Services Commercial |
$2.65
|
|
|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
IP
|
$10.40
|
|
|
Service Code
|
NDC 69238-1266-1
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Adventist Health Commercial |
$2.08
|
| Rate for Payer: Blue Shield of California Commercial |
$8.04
|
| Rate for Payer: Blue Shield of California EPN |
$5.24
|
| Rate for Payer: Cash Price |
$5.72
|
| Rate for Payer: Central Health Plan Commercial |
$8.32
|
| Rate for Payer: Cigna of CA HMO |
$7.28
|
| Rate for Payer: Cigna of CA PPO |
$7.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.16
|
| Rate for Payer: EPIC Health Plan Senior |
$4.16
|
| Rate for Payer: Galaxy Health WC |
$8.84
|
| Rate for Payer: Global Benefits Group Commercial |
$6.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.08
|
| Rate for Payer: Multiplan Commercial |
$7.80
|
| Rate for Payer: Networks By Design Commercial |
$6.76
|
| Rate for Payer: Prime Health Services Commercial |
$8.84
|
|
|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
OP
|
$3.12
|
|
|
Service Code
|
NDC 31722-632-31
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.62 |
| Max. Negotiated Rate |
$2.81 |
| Rate for Payer: Adventist Health Commercial |
$0.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.65
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.83
|
| Rate for Payer: Blue Shield of California Commercial |
$1.91
|
| Rate for Payer: Blue Shield of California EPN |
$1.24
|
| Rate for Payer: Cash Price |
$1.72
|
| Rate for Payer: Central Health Plan Commercial |
$2.50
|
| Rate for Payer: Cigna of CA HMO |
$2.18
|
| Rate for Payer: Cigna of CA PPO |
$2.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.65
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.65
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.25
|
| Rate for Payer: EPIC Health Plan Senior |
$1.25
|
| Rate for Payer: Galaxy Health WC |
$2.65
|
| Rate for Payer: Global Benefits Group Commercial |
$1.87
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.81
|
| Rate for Payer: InnovAge PACE Commercial |
$1.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.93
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.18
|
| Rate for Payer: Multiplan Commercial |
$2.34
|
| Rate for Payer: Networks By Design Commercial |
$2.03
|
| Rate for Payer: Prime Health Services Commercial |
$2.65
|
| Rate for Payer: Riverside University Health System MISP |
$1.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.87
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.56
|
| Rate for Payer: United Healthcare All Other HMO |
$1.56
|
| Rate for Payer: United Healthcare HMO Rider |
$1.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.65
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.65
|
| Rate for Payer: Vantage Medical Group Senior |
$2.65
|
|
|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
IP
|
$2.22
|
|
|
Service Code
|
NDC 64380-799-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Adventist Health Commercial |
$0.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.72
|
| Rate for Payer: Blue Shield of California EPN |
$1.12
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: Central Health Plan Commercial |
$1.78
|
| Rate for Payer: Cigna of CA HMO |
$1.55
|
| Rate for Payer: Cigna of CA PPO |
$1.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.89
|
| Rate for Payer: EPIC Health Plan Senior |
$0.89
|
| Rate for Payer: Galaxy Health WC |
$1.89
|
| Rate for Payer: Global Benefits Group Commercial |
$1.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.44
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Networks By Design Commercial |
$1.44
|
| Rate for Payer: Prime Health Services Commercial |
$1.89
|
|
|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
OP
|
$2.22
|
|
|
Service Code
|
NDC 72205-044-11
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.44 |
| Max. Negotiated Rate |
$2.00 |
| Rate for Payer: Adventist Health Commercial |
$0.44
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.89
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.22
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.30
|
| Rate for Payer: Blue Shield of California Commercial |
$1.36
|
| Rate for Payer: Blue Shield of California EPN |
$0.89
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: Central Health Plan Commercial |
$1.78
|
| Rate for Payer: Cigna of CA HMO |
$1.55
|
| Rate for Payer: Cigna of CA PPO |
$1.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.89
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.89
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.89
|
| Rate for Payer: EPIC Health Plan Senior |
$0.89
|
| Rate for Payer: Galaxy Health WC |
$1.89
|
| Rate for Payer: Global Benefits Group Commercial |
$1.33
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.00
|
| Rate for Payer: InnovAge PACE Commercial |
$1.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.85
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.55
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.55
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Networks By Design Commercial |
$1.44
|
| Rate for Payer: Prime Health Services Commercial |
$1.89
|
| Rate for Payer: Riverside University Health System MISP |
$0.89
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.33
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.11
|
| Rate for Payer: United Healthcare All Other HMO |
$1.11
|
| Rate for Payer: United Healthcare HMO Rider |
$1.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.11
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.89
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.89
|
| Rate for Payer: Vantage Medical Group Senior |
$1.89
|
|
|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
OP
|
$10.40
|
|
|
Service Code
|
NDC 69238-1266-1
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.08 |
| Max. Negotiated Rate |
$9.36 |
| Rate for Payer: Adventist Health Commercial |
$2.08
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.80
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.04
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.11
|
| Rate for Payer: Blue Shield of California Commercial |
$6.35
|
| Rate for Payer: Blue Shield of California EPN |
$4.15
|
| Rate for Payer: Cash Price |
$5.72
|
| Rate for Payer: Central Health Plan Commercial |
$8.32
|
| Rate for Payer: Cigna of CA HMO |
$7.28
|
| Rate for Payer: Cigna of CA PPO |
$7.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.84
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.16
|
| Rate for Payer: EPIC Health Plan Senior |
$4.16
|
| Rate for Payer: Galaxy Health WC |
$8.84
|
| Rate for Payer: Global Benefits Group Commercial |
$6.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.36
|
| Rate for Payer: InnovAge PACE Commercial |
$5.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.08
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.28
|
| Rate for Payer: Multiplan Commercial |
$7.80
|
| Rate for Payer: Networks By Design Commercial |
$6.76
|
| Rate for Payer: Prime Health Services Commercial |
$8.84
|
| Rate for Payer: Riverside University Health System MISP |
$4.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.20
|
| Rate for Payer: United Healthcare All Other HMO |
$5.20
|
| Rate for Payer: United Healthcare HMO Rider |
$5.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.84
|
| Rate for Payer: Vantage Medical Group Senior |
$8.84
|
|
|
OSELTAMIVIR 75 MG CAPSULE [26546]
|
Facility
|
OP
|
$18.23
|
|
|
Service Code
|
NDC 0004-0800-85
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.65 |
| Max. Negotiated Rate |
$16.41 |
| Rate for Payer: Adventist Health Commercial |
$3.65
|
| Rate for Payer: Aetna of CA HMO/PPO |
$11.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$8.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.71
|
| Rate for Payer: Blue Shield of California Commercial |
$11.14
|
| Rate for Payer: Blue Shield of California EPN |
$7.27
|
| Rate for Payer: Cash Price |
$10.02
|
| Rate for Payer: Central Health Plan Commercial |
$14.58
|
| Rate for Payer: Cigna of CA HMO |
$12.76
|
| Rate for Payer: Cigna of CA PPO |
$12.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.29
|
| Rate for Payer: EPIC Health Plan Senior |
$7.29
|
| Rate for Payer: Galaxy Health WC |
$15.50
|
| Rate for Payer: Global Benefits Group Commercial |
$10.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.41
|
| Rate for Payer: InnovAge PACE Commercial |
$9.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.16
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.65
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$12.76
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$12.76
|
| Rate for Payer: Multiplan Commercial |
$13.67
|
| Rate for Payer: Networks By Design Commercial |
$11.85
|
| Rate for Payer: Prime Health Services Commercial |
$15.50
|
| Rate for Payer: Riverside University Health System MISP |
$7.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.94
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.12
|
| Rate for Payer: United Healthcare All Other HMO |
$9.12
|
| Rate for Payer: United Healthcare HMO Rider |
$9.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.50
|
| Rate for Payer: Vantage Medical Group Senior |
$15.50
|
|
|
OSTOMY ADHESIVE PASTE [115464]
|
Facility
|
OP
|
$0.16
|
|
|
Service Code
|
NDC 6845510690
|
| Hospital Charge Code |
901700016
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.09
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California EPN |
$0.06
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Central Health Plan Commercial |
$0.13
|
| Rate for Payer: Cigna of CA HMO |
$0.10
|
| Rate for Payer: Cigna of CA PPO |
$0.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.14
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.06
|
| Rate for Payer: EPIC Health Plan Senior |
$0.06
|
| Rate for Payer: Galaxy Health WC |
$0.14
|
| Rate for Payer: Global Benefits Group Commercial |
$0.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.14
|
| Rate for Payer: InnovAge PACE Commercial |
$0.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.11
|
| Rate for Payer: Multiplan Commercial |
$0.12
|
| Rate for Payer: Networks By Design Commercial |
$0.10
|
| Rate for Payer: Prime Health Services Commercial |
$0.14
|
| Rate for Payer: Riverside University Health System MISP |
$0.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.08
|
| Rate for Payer: United Healthcare All Other HMO |
$0.08
|
| Rate for Payer: United Healthcare HMO Rider |
$0.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: Vantage Medical Group Senior |
$0.14
|
|
|
OSTOMY ADHESIVE PASTE [115464]
|
Facility
|
IP
|
$0.16
|
|
|
Service Code
|
NDC 6845510690
|
| Hospital Charge Code |
901700016
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Central Health Plan Commercial |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.06
|
| Rate for Payer: EPIC Health Plan Senior |
$0.06
|
| Rate for Payer: Galaxy Health WC |
$0.14
|
| Rate for Payer: Global Benefits Group Commercial |
$0.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Multiplan Commercial |
$0.12
|
| Rate for Payer: Networks By Design Commercial |
$0.10
|
| Rate for Payer: Prime Health Services Commercial |
$0.14
|
|
|
OSTOMY SUPPLIES POWDER [110541]
|
Facility
|
IP
|
$0.26
|
|
|
Service Code
|
NDC 6845510826
|
| Hospital Charge Code |
901700016
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.23 |
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Central Health Plan Commercial |
$0.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Senior |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
|
|
OSTOMY SUPPLIES POWDER [110541]
|
Facility
|
OP
|
$0.26
|
|
|
Service Code
|
NDC 6845510826
|
| Hospital Charge Code |
901700016
|
|
Hospital Revenue Code
|
271
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.23 |
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.15
|
| Rate for Payer: Blue Shield of California Commercial |
$0.16
|
| Rate for Payer: Blue Shield of California EPN |
$0.10
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Central Health Plan Commercial |
$0.21
|
| Rate for Payer: Cigna of CA HMO |
$0.17
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Senior |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.23
|
| Rate for Payer: InnovAge PACE Commercial |
$0.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.18
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
| Rate for Payer: Riverside University Health System MISP |
$0.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
| Rate for Payer: United Healthcare All Other HMO |
$0.13
|
| Rate for Payer: United Healthcare HMO Rider |
$0.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.22
|
| Rate for Payer: Vantage Medical Group Senior |
$0.22
|
|
|
OXACILLIN 10 GRAM SOLUTION FOR INJECTION [5925]
|
Facility
|
IP
|
$140.16
|
|
|
Service Code
|
HCPCS J2700
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$28.03 |
| Max. Negotiated Rate |
$126.14 |
| Rate for Payer: Adventist Health Commercial |
$28.03
|
| Rate for Payer: Adventist Health Commercial |
$26.64
|
| Rate for Payer: Blue Shield of California Commercial |
$108.34
|
| Rate for Payer: Blue Shield of California Commercial |
$102.96
|
| Rate for Payer: Blue Shield of California EPN |
$67.13
|
| Rate for Payer: Blue Shield of California EPN |
$70.64
|
| Rate for Payer: Cash Price |
$77.09
|
| Rate for Payer: Cash Price |
$73.26
|
| Rate for Payer: Central Health Plan Commercial |
$112.13
|
| Rate for Payer: Central Health Plan Commercial |
$106.56
|
| Rate for Payer: Cigna of CA HMO |
$93.24
|
| Rate for Payer: Cigna of CA HMO |
$98.11
|
| Rate for Payer: Cigna of CA PPO |
$93.24
|
| Rate for Payer: Cigna of CA PPO |
$98.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.06
|
| Rate for Payer: EPIC Health Plan Senior |
$53.28
|
| Rate for Payer: EPIC Health Plan Senior |
$56.06
|
| Rate for Payer: Galaxy Health WC |
$113.22
|
| Rate for Payer: Galaxy Health WC |
$119.14
|
| Rate for Payer: Global Benefits Group Commercial |
$84.10
|
| Rate for Payer: Global Benefits Group Commercial |
$79.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$119.88
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$50.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.45
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.76
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.64
|
| Rate for Payer: Multiplan Commercial |
$99.90
|
| Rate for Payer: Multiplan Commercial |
$105.12
|
| Rate for Payer: Networks By Design Commercial |
$66.60
|
| Rate for Payer: Networks By Design Commercial |
$70.08
|
| Rate for Payer: Prime Health Services Commercial |
$119.14
|
| Rate for Payer: Prime Health Services Commercial |
$113.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.60
|
| Rate for Payer: United Healthcare All Other HMO |
$51.20
|
| Rate for Payer: United Healthcare All Other HMO |
$48.66
|
| Rate for Payer: United Healthcare HMO Rider |
$47.61
|
| Rate for Payer: United Healthcare HMO Rider |
$50.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45.90
|
|
|
OXACILLIN 10 GRAM SOLUTION FOR INJECTION [5925]
|
Facility
|
OP
|
$133.20
|
|
|
Service Code
|
HCPCS J2700
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$119.88 |
| Rate for Payer: Adventist Health Commercial |
$26.64
|
| Rate for Payer: Adventist Health Commercial |
$28.03
|
| Rate for Payer: Aetna of CA HMO/PPO |
$85.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$80.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$119.14
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$113.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$77.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$73.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$105.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$99.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.48
|
| Rate for Payer: Blue Shield of California Commercial |
$3.15
|
| Rate for Payer: Blue Shield of California Commercial |
$3.15
|
| Rate for Payer: Blue Shield of California EPN |
$2.86
|
| Rate for Payer: Blue Shield of California EPN |
$2.86
|
| Rate for Payer: Cash Price |
$73.26
|
| Rate for Payer: Cash Price |
$73.26
|
| Rate for Payer: Cash Price |
$77.09
|
| Rate for Payer: Cash Price |
$77.09
|
| Rate for Payer: Central Health Plan Commercial |
$106.56
|
| Rate for Payer: Central Health Plan Commercial |
$112.13
|
| Rate for Payer: Cigna of CA HMO |
$98.11
|
| Rate for Payer: Cigna of CA HMO |
$93.24
|
| Rate for Payer: Cigna of CA PPO |
$98.11
|
| Rate for Payer: Cigna of CA PPO |
$93.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$113.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$119.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$119.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$113.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$113.22
|
| Rate for Payer: Dignity Health Medicare Advantage |
$119.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$53.28
|
| Rate for Payer: EPIC Health Plan Senior |
$53.28
|
| Rate for Payer: EPIC Health Plan Senior |
$56.06
|
| Rate for Payer: Galaxy Health WC |
$119.14
|
| Rate for Payer: Galaxy Health WC |
$113.22
|
| Rate for Payer: Global Benefits Group Commercial |
$84.10
|
| Rate for Payer: Global Benefits Group Commercial |
$79.92
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$119.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.64
|
| Rate for Payer: InnovAge PACE Commercial |
$66.60
|
| Rate for Payer: InnovAge PACE Commercial |
$70.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$88.84
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.76
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$82.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$26.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$93.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$98.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$98.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$93.24
|
| Rate for Payer: Multiplan Commercial |
$99.90
|
| Rate for Payer: Multiplan Commercial |
$105.12
|
| Rate for Payer: Networks By Design Commercial |
$70.08
|
| Rate for Payer: Networks By Design Commercial |
$66.60
|
| Rate for Payer: Prime Health Services Commercial |
$119.14
|
| Rate for Payer: Prime Health Services Commercial |
$113.22
|
| Rate for Payer: Riverside University Health System MISP |
$53.28
|
| Rate for Payer: Riverside University Health System MISP |
$56.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$84.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$79.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$79.92
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$84.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$49.99
|
| Rate for Payer: United Healthcare All Other HMO |
$48.66
|
| Rate for Payer: United Healthcare All Other HMO |
$51.20
|
| Rate for Payer: United Healthcare HMO Rider |
$47.61
|
| Rate for Payer: United Healthcare HMO Rider |
$50.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$43.62
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$45.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$113.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$119.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$113.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$119.14
|
| Rate for Payer: Vantage Medical Group Senior |
$113.22
|
| Rate for Payer: Vantage Medical Group Senior |
$119.14
|
|
|
OXACILLIN 1 GRAM SOLUTION FOR INJECTION [5924]
|
Facility
|
OP
|
$13.56
|
|
|
Service Code
|
HCPCS J2700
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$12.20 |
| Rate for Payer: Adventist Health Commercial |
$2.71
|
| Rate for Payer: Adventist Health Commercial |
$1.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$10.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.48
|
| Rate for Payer: Blue Shield of California Commercial |
$3.15
|
| Rate for Payer: Blue Shield of California Commercial |
$3.15
|
| Rate for Payer: Blue Shield of California EPN |
$2.86
|
| Rate for Payer: Blue Shield of California EPN |
$2.86
|
| Rate for Payer: Cash Price |
$7.46
|
| Rate for Payer: Cash Price |
$7.46
|
| Rate for Payer: Cash Price |
$5.47
|
| Rate for Payer: Cash Price |
$5.47
|
| Rate for Payer: Central Health Plan Commercial |
$10.85
|
| Rate for Payer: Central Health Plan Commercial |
$7.96
|
| Rate for Payer: Cigna of CA HMO |
$6.96
|
| Rate for Payer: Cigna of CA HMO |
$9.49
|
| Rate for Payer: Cigna of CA PPO |
$6.96
|
| Rate for Payer: Cigna of CA PPO |
$9.49
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.53
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$11.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.42
|
| Rate for Payer: EPIC Health Plan Senior |
$5.42
|
| Rate for Payer: EPIC Health Plan Senior |
$3.98
|
| Rate for Payer: Galaxy Health WC |
$8.46
|
| Rate for Payer: Galaxy Health WC |
$11.53
|
| Rate for Payer: Global Benefits Group Commercial |
$5.97
|
| Rate for Payer: Global Benefits Group Commercial |
$8.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.64
|
| Rate for Payer: InnovAge PACE Commercial |
$6.78
|
| Rate for Payer: InnovAge PACE Commercial |
$4.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.71
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$9.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.96
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$9.49
|
| Rate for Payer: Multiplan Commercial |
$10.17
|
| Rate for Payer: Multiplan Commercial |
$7.46
|
| Rate for Payer: Networks By Design Commercial |
$4.97
|
| Rate for Payer: Networks By Design Commercial |
$6.78
|
| Rate for Payer: Prime Health Services Commercial |
$8.46
|
| Rate for Payer: Prime Health Services Commercial |
$11.53
|
| Rate for Payer: Riverside University Health System MISP |
$5.42
|
| Rate for Payer: Riverside University Health System MISP |
$3.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.97
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.73
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.09
|
| Rate for Payer: United Healthcare All Other HMO |
$4.95
|
| Rate for Payer: United Healthcare All Other HMO |
$3.63
|
| Rate for Payer: United Healthcare HMO Rider |
$4.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11.53
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.46
|
| Rate for Payer: Vantage Medical Group Senior |
$11.53
|
| Rate for Payer: Vantage Medical Group Senior |
$8.46
|
|
|
OXACILLIN 1 GRAM SOLUTION FOR INJECTION [5924]
|
Facility
|
IP
|
$9.95
|
|
|
Service Code
|
HCPCS J2700
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.99 |
| Max. Negotiated Rate |
$8.96 |
| Rate for Payer: Adventist Health Commercial |
$1.99
|
| Rate for Payer: Adventist Health Commercial |
$2.71
|
| Rate for Payer: Blue Shield of California Commercial |
$7.69
|
| Rate for Payer: Blue Shield of California Commercial |
$10.48
|
| Rate for Payer: Blue Shield of California EPN |
$6.83
|
| Rate for Payer: Blue Shield of California EPN |
$5.01
|
| Rate for Payer: Cash Price |
$5.47
|
| Rate for Payer: Cash Price |
$7.46
|
| Rate for Payer: Central Health Plan Commercial |
$7.96
|
| Rate for Payer: Central Health Plan Commercial |
$10.85
|
| Rate for Payer: Cigna of CA HMO |
$9.49
|
| Rate for Payer: Cigna of CA HMO |
$6.96
|
| Rate for Payer: Cigna of CA PPO |
$9.49
|
| Rate for Payer: Cigna of CA PPO |
$6.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.98
|
| Rate for Payer: EPIC Health Plan Senior |
$5.42
|
| Rate for Payer: EPIC Health Plan Senior |
$3.98
|
| Rate for Payer: Galaxy Health WC |
$11.53
|
| Rate for Payer: Galaxy Health WC |
$8.46
|
| Rate for Payer: Global Benefits Group Commercial |
$5.97
|
| Rate for Payer: Global Benefits Group Commercial |
$8.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.79
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.17
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$8.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.71
|
| Rate for Payer: Multiplan Commercial |
$10.17
|
| Rate for Payer: Multiplan Commercial |
$7.46
|
| Rate for Payer: Networks By Design Commercial |
$6.78
|
| Rate for Payer: Networks By Design Commercial |
$4.97
|
| Rate for Payer: Prime Health Services Commercial |
$8.46
|
| Rate for Payer: Prime Health Services Commercial |
$11.53
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.73
|
| Rate for Payer: United Healthcare All Other HMO |
$3.63
|
| Rate for Payer: United Healthcare All Other HMO |
$4.95
|
| Rate for Payer: United Healthcare HMO Rider |
$4.85
|
| Rate for Payer: United Healthcare HMO Rider |
$3.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.26
|
|
|
OXACILLIN 2 GRAM SOLUTION FOR INJECTION [5926]
|
Facility
|
OP
|
$27.12
|
|
|
Service Code
|
HCPCS J2700
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.64 |
| Max. Negotiated Rate |
$24.41 |
| Rate for Payer: Adventist Health Commercial |
$5.42
|
| Rate for Payer: Adventist Health Commercial |
$5.61
|
| Rate for Payer: Adventist Health Commercial |
$2.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$17.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6.56
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.83
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$14.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$15.42
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.10
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$20.34
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$21.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.48
|
| Rate for Payer: Blue Shield of California Commercial |
$3.15
|
| Rate for Payer: Blue Shield of California Commercial |
$3.15
|
| Rate for Payer: Blue Shield of California Commercial |
$3.15
|
| Rate for Payer: Blue Shield of California EPN |
$2.86
|
| Rate for Payer: Blue Shield of California EPN |
$2.86
|
| Rate for Payer: Blue Shield of California EPN |
$2.86
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Cash Price |
$14.92
|
| Rate for Payer: Cash Price |
$14.92
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Central Health Plan Commercial |
$22.42
|
| Rate for Payer: Central Health Plan Commercial |
$21.70
|
| Rate for Payer: Central Health Plan Commercial |
$8.64
|
| Rate for Payer: Cigna of CA HMO |
$19.62
|
| Rate for Payer: Cigna of CA HMO |
$18.98
|
| Rate for Payer: Cigna of CA HMO |
$7.56
|
| Rate for Payer: Cigna of CA PPO |
$7.56
|
| Rate for Payer: Cigna of CA PPO |
$19.62
|
| Rate for Payer: Cigna of CA PPO |
$18.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.05
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$23.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.21
|
| Rate for Payer: EPIC Health Plan Senior |
$4.32
|
| Rate for Payer: EPIC Health Plan Senior |
$10.85
|
| Rate for Payer: EPIC Health Plan Senior |
$11.21
|
| Rate for Payer: Galaxy Health WC |
$23.83
|
| Rate for Payer: Galaxy Health WC |
$9.18
|
| Rate for Payer: Galaxy Health WC |
$23.05
|
| Rate for Payer: Global Benefits Group Commercial |
$6.48
|
| Rate for Payer: Global Benefits Group Commercial |
$16.82
|
| Rate for Payer: Global Benefits Group Commercial |
$16.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.72
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.64
|
| Rate for Payer: InnovAge PACE Commercial |
$14.02
|
| Rate for Payer: InnovAge PACE Commercial |
$13.56
|
| Rate for Payer: InnovAge PACE Commercial |
$5.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$19.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$18.98
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$7.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$7.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$18.98
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$19.62
|
| Rate for Payer: Multiplan Commercial |
$21.02
|
| Rate for Payer: Multiplan Commercial |
$8.10
|
| Rate for Payer: Multiplan Commercial |
$20.34
|
| Rate for Payer: Networks By Design Commercial |
$5.40
|
| Rate for Payer: Networks By Design Commercial |
$14.02
|
| Rate for Payer: Networks By Design Commercial |
$13.56
|
| Rate for Payer: Prime Health Services Commercial |
$23.05
|
| Rate for Payer: Prime Health Services Commercial |
$23.83
|
| Rate for Payer: Prime Health Services Commercial |
$9.18
|
| Rate for Payer: Riverside University Health System MISP |
$11.21
|
| Rate for Payer: Riverside University Health System MISP |
$10.85
|
| Rate for Payer: Riverside University Health System MISP |
$4.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.27
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.05
|
| Rate for Payer: United Healthcare All Other HMO |
$3.95
|
| Rate for Payer: United Healthcare All Other HMO |
$9.91
|
| Rate for Payer: United Healthcare All Other HMO |
$10.24
|
| Rate for Payer: United Healthcare HMO Rider |
$9.69
|
| Rate for Payer: United Healthcare HMO Rider |
$3.86
|
| Rate for Payer: United Healthcare HMO Rider |
$10.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.54
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.88
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.05
|
| Rate for Payer: Vantage Medical Group Senior |
$23.05
|
| Rate for Payer: Vantage Medical Group Senior |
$9.18
|
| Rate for Payer: Vantage Medical Group Senior |
$23.83
|
|
|
OXACILLIN 2 GRAM SOLUTION FOR INJECTION [5926]
|
Facility
|
IP
|
$28.03
|
|
|
Service Code
|
HCPCS J2700
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.61 |
| Max. Negotiated Rate |
$25.23 |
| Rate for Payer: Adventist Health Commercial |
$5.61
|
| Rate for Payer: Adventist Health Commercial |
$5.42
|
| Rate for Payer: Adventist Health Commercial |
$2.16
|
| Rate for Payer: Blue Shield of California Commercial |
$21.67
|
| Rate for Payer: Blue Shield of California Commercial |
$20.96
|
| Rate for Payer: Blue Shield of California Commercial |
$8.35
|
| Rate for Payer: Blue Shield of California EPN |
$5.44
|
| Rate for Payer: Blue Shield of California EPN |
$14.13
|
| Rate for Payer: Blue Shield of California EPN |
$13.67
|
| Rate for Payer: Cash Price |
$15.42
|
| Rate for Payer: Cash Price |
$5.94
|
| Rate for Payer: Cash Price |
$14.92
|
| Rate for Payer: Central Health Plan Commercial |
$21.70
|
| Rate for Payer: Central Health Plan Commercial |
$8.64
|
| Rate for Payer: Central Health Plan Commercial |
$22.42
|
| Rate for Payer: Cigna of CA HMO |
$19.62
|
| Rate for Payer: Cigna of CA HMO |
$7.56
|
| Rate for Payer: Cigna of CA HMO |
$18.98
|
| Rate for Payer: Cigna of CA PPO |
$19.62
|
| Rate for Payer: Cigna of CA PPO |
$18.98
|
| Rate for Payer: Cigna of CA PPO |
$7.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.32
|
| Rate for Payer: EPIC Health Plan Senior |
$10.85
|
| Rate for Payer: EPIC Health Plan Senior |
$4.32
|
| Rate for Payer: EPIC Health Plan Senior |
$11.21
|
| Rate for Payer: Galaxy Health WC |
$23.05
|
| Rate for Payer: Galaxy Health WC |
$9.18
|
| Rate for Payer: Galaxy Health WC |
$23.83
|
| Rate for Payer: Global Benefits Group Commercial |
$16.27
|
| Rate for Payer: Global Benefits Group Commercial |
$6.48
|
| Rate for Payer: Global Benefits Group Commercial |
$16.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$25.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$18.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.68
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$17.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$16.79
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$6.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.16
|
| Rate for Payer: Multiplan Commercial |
$21.02
|
| Rate for Payer: Multiplan Commercial |
$20.34
|
| Rate for Payer: Multiplan Commercial |
$8.10
|
| Rate for Payer: Networks By Design Commercial |
$14.02
|
| Rate for Payer: Networks By Design Commercial |
$5.40
|
| Rate for Payer: Networks By Design Commercial |
$13.56
|
| Rate for Payer: Prime Health Services Commercial |
$23.05
|
| Rate for Payer: Prime Health Services Commercial |
$23.83
|
| Rate for Payer: Prime Health Services Commercial |
$9.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.52
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.18
|
| Rate for Payer: United Healthcare All Other HMO |
$9.91
|
| Rate for Payer: United Healthcare All Other HMO |
$3.95
|
| Rate for Payer: United Healthcare All Other HMO |
$10.24
|
| Rate for Payer: United Healthcare HMO Rider |
$3.86
|
| Rate for Payer: United Healthcare HMO Rider |
$9.69
|
| Rate for Payer: United Healthcare HMO Rider |
$10.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.54
|
|
|
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION [99612]
|
Facility
|
IP
|
$6.00
|
|
|
Service Code
|
HCPCS J9263
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.20 |
| Max. Negotiated Rate |
$5.40 |
| Rate for Payer: Adventist Health Commercial |
$1.20
|
| Rate for Payer: Adventist Health Commercial |
$0.86
|
| Rate for Payer: Adventist Health Commercial |
$0.24
|
| Rate for Payer: Blue Shield of California Commercial |
$4.64
|
| Rate for Payer: Blue Shield of California Commercial |
$3.34
|
| Rate for Payer: Blue Shield of California Commercial |
$0.93
|
| Rate for Payer: Blue Shield of California EPN |
$0.60
|
| Rate for Payer: Blue Shield of California EPN |
$3.02
|
| Rate for Payer: Blue Shield of California EPN |
$2.18
|
| Rate for Payer: Cash Price |
$3.30
|
| Rate for Payer: Cash Price |
$0.66
|
| Rate for Payer: Cash Price |
$2.38
|
| Rate for Payer: Central Health Plan Commercial |
$3.46
|
| Rate for Payer: Central Health Plan Commercial |
$0.96
|
| Rate for Payer: Central Health Plan Commercial |
$4.80
|
| Rate for Payer: Cigna of CA HMO |
$4.20
|
| Rate for Payer: Cigna of CA HMO |
$0.84
|
| Rate for Payer: Cigna of CA HMO |
$3.02
|
| Rate for Payer: Cigna of CA PPO |
$4.20
|
| Rate for Payer: Cigna of CA PPO |
$3.02
|
| Rate for Payer: Cigna of CA PPO |
$0.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1.73
|
| Rate for Payer: EPIC Health Plan Senior |
$0.48
|
| Rate for Payer: EPIC Health Plan Senior |
$2.40
|
| Rate for Payer: Galaxy Health WC |
$3.67
|
| Rate for Payer: Galaxy Health WC |
$1.02
|
| Rate for Payer: Galaxy Health WC |
$5.10
|
| Rate for Payer: Global Benefits Group Commercial |
$2.59
|
| Rate for Payer: Global Benefits Group Commercial |
$0.72
|
| Rate for Payer: Global Benefits Group Commercial |
$3.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.88
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.65
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.67
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$4.50
|
| Rate for Payer: Multiplan Commercial |
$3.24
|
| Rate for Payer: Multiplan Commercial |
$0.90
|
| Rate for Payer: Networks By Design Commercial |
$3.00
|
| Rate for Payer: Networks By Design Commercial |
$0.60
|
| Rate for Payer: Networks By Design Commercial |
$2.16
|
| Rate for Payer: Prime Health Services Commercial |
$3.67
|
| Rate for Payer: Prime Health Services Commercial |
$5.10
|
| Rate for Payer: Prime Health Services Commercial |
$1.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.25
|
| 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 All Other HMO |
$0.44
|
| Rate for Payer: United Healthcare All Other HMO |
$2.19
|
| Rate for Payer: United Healthcare HMO Rider |
$0.43
|
| Rate for Payer: United Healthcare HMO Rider |
$1.54
|
| Rate for Payer: United Healthcare HMO Rider |
$2.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.39
|
|
|
OXALIPLATIN 100 MG/20 ML INTRAVENOUS SOLUTION [99612]
|
Facility
|
OP
|
$4.32
|
|
|
Service Code
|
HCPCS J9263
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$3.89 |
| Rate for Payer: Adventist Health Commercial |
$0.86
|
| Rate for Payer: Adventist Health Commercial |
$1.20
|
| Rate for Payer: Adventist Health Commercial |
$0.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.64
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.73
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.62
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.38
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.26
|
| Rate for Payer: Blue Shield of California Commercial |
$0.47
|
| Rate for Payer: Blue Shield of California Commercial |
$0.47
|
| Rate for Payer: Blue Shield of California Commercial |
$0.47
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Cash Price |
$3.30
|
| Rate for Payer: Cash Price |
$0.66
|
| Rate for Payer: Cash Price |
$0.66
|
| Rate for Payer: Cash Price |
$2.38
|
| Rate for Payer: Cash Price |
$2.38
|
| Rate for Payer: Cash Price |
$3.30
|
| Rate for Payer: Central Health Plan Commercial |
$4.80
|
| Rate for Payer: Central Health Plan Commercial |
$3.46
|
| Rate for Payer: Central Health Plan Commercial |
$0.96
|
| Rate for Payer: Cigna of CA HMO |
$4.20
|
| Rate for Payer: Cigna of CA HMO |
$3.02
|
| Rate for Payer: Cigna of CA HMO |
$0.84
|
| Rate for Payer: Cigna of CA PPO |
$0.84
|
| Rate for Payer: Cigna of CA PPO |
$4.20
|
| Rate for Payer: Cigna of CA PPO |
$3.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.40
|
| Rate for Payer: EPIC Health Plan Senior |
$0.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1.73
|
| Rate for Payer: EPIC Health Plan Senior |
$2.40
|
| Rate for Payer: Galaxy Health WC |
$5.10
|
| Rate for Payer: Galaxy Health WC |
$1.02
|
| Rate for Payer: Galaxy Health WC |
$3.67
|
| Rate for Payer: Global Benefits Group Commercial |
$0.72
|
| Rate for Payer: Global Benefits Group Commercial |
$3.60
|
| Rate for Payer: Global Benefits Group Commercial |
$2.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.08
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.05
|
| Rate for Payer: InnovAge PACE Commercial |
$3.00
|
| Rate for Payer: InnovAge PACE Commercial |
$2.16
|
| Rate for Payer: InnovAge PACE Commercial |
$0.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.84
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.20
|
| Rate for Payer: Multiplan Commercial |
$4.50
|
| Rate for Payer: Multiplan Commercial |
$0.90
|
| Rate for Payer: Multiplan Commercial |
$3.24
|
| Rate for Payer: Networks By Design Commercial |
$0.60
|
| Rate for Payer: Networks By Design Commercial |
$3.00
|
| Rate for Payer: Networks By Design Commercial |
$2.16
|
| Rate for Payer: Prime Health Services Commercial |
$3.67
|
| Rate for Payer: Prime Health Services Commercial |
$5.10
|
| Rate for Payer: Prime Health Services Commercial |
$1.02
|
| Rate for Payer: Riverside University Health System MISP |
$2.40
|
| Rate for Payer: Riverside University Health System MISP |
$1.73
|
| Rate for Payer: Riverside University Health System MISP |
$0.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.59
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.72
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.62
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.45
|
| Rate for Payer: United Healthcare All Other HMO |
$0.44
|
| Rate for Payer: United Healthcare All Other HMO |
$1.58
|
| Rate for Payer: United Healthcare All Other HMO |
$2.19
|
| Rate for Payer: United Healthcare HMO Rider |
$1.54
|
| Rate for Payer: United Healthcare HMO Rider |
$0.43
|
| Rate for Payer: United Healthcare HMO Rider |
$2.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.39
|
| 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 Commercial/Exchange |
$1.02
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.67
|
| Rate for Payer: Vantage Medical Group Senior |
$3.67
|
| Rate for Payer: Vantage Medical Group Senior |
$1.02
|
| Rate for Payer: Vantage Medical Group Senior |
$5.10
|
|
|
OXALIPLATIN 100 MG INTRAVENOUS SOLUTION [23929]
|
Facility
|
OP
|
$126.48
|
|
|
Service Code
|
HCPCS J9263
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$113.83 |
| Rate for Payer: Adventist Health Commercial |
$25.30
|
| Rate for Payer: Adventist Health Commercial |
$127.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$386.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$76.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$540.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$107.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$349.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$69.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$477.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$94.86
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.26
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.26
|
| Rate for Payer: Blue Shield of California Commercial |
$0.47
|
| Rate for Payer: Blue Shield of California Commercial |
$0.47
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.43
|
| Rate for Payer: Cash Price |
$69.56
|
| Rate for Payer: Cash Price |
$69.56
|
| Rate for Payer: Cash Price |
$349.80
|
| Rate for Payer: Cash Price |
$349.80
|
| Rate for Payer: Central Health Plan Commercial |
$101.18
|
| Rate for Payer: Central Health Plan Commercial |
$508.80
|
| Rate for Payer: Cigna of CA HMO |
$445.20
|
| Rate for Payer: Cigna of CA HMO |
$88.54
|
| Rate for Payer: Cigna of CA PPO |
$445.20
|
| Rate for Payer: Cigna of CA PPO |
$88.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$107.51
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$540.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$540.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$107.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$107.51
|
| Rate for Payer: Dignity Health Medicare Advantage |
$540.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.59
|
| Rate for Payer: EPIC Health Plan Senior |
$50.59
|
| Rate for Payer: EPIC Health Plan Senior |
$254.40
|
| Rate for Payer: Galaxy Health WC |
$540.60
|
| Rate for Payer: Galaxy Health WC |
$107.51
|
| Rate for Payer: Global Benefits Group Commercial |
$381.60
|
| Rate for Payer: Global Benefits Group Commercial |
$75.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$572.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$113.83
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.05
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.05
|
| Rate for Payer: InnovAge PACE Commercial |
$63.24
|
| Rate for Payer: InnovAge PACE Commercial |
$318.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$84.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$424.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$393.68
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$88.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$445.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$445.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$88.54
|
| Rate for Payer: Multiplan Commercial |
$94.86
|
| Rate for Payer: Multiplan Commercial |
$477.00
|
| Rate for Payer: Networks By Design Commercial |
$318.00
|
| Rate for Payer: Networks By Design Commercial |
$63.24
|
| Rate for Payer: Prime Health Services Commercial |
$540.60
|
| Rate for Payer: Prime Health Services Commercial |
$107.51
|
| Rate for Payer: Riverside University Health System MISP |
$50.59
|
| Rate for Payer: Riverside University Health System MISP |
$254.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$381.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$75.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$75.89
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$381.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$238.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.47
|
| Rate for Payer: United Healthcare All Other HMO |
$46.20
|
| Rate for Payer: United Healthcare All Other HMO |
$232.33
|
| Rate for Payer: United Healthcare HMO Rider |
$45.20
|
| Rate for Payer: United Healthcare HMO Rider |
$227.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$208.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$107.51
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$540.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$107.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$540.60
|
| Rate for Payer: Vantage Medical Group Senior |
$107.51
|
| Rate for Payer: Vantage Medical Group Senior |
$540.60
|
|
|
OXALIPLATIN 100 MG INTRAVENOUS SOLUTION [23929]
|
Facility
|
IP
|
$636.00
|
|
|
Service Code
|
HCPCS J9263
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$127.20 |
| Max. Negotiated Rate |
$572.40 |
| Rate for Payer: Adventist Health Commercial |
$127.20
|
| Rate for Payer: Adventist Health Commercial |
$25.30
|
| Rate for Payer: Blue Shield of California Commercial |
$491.63
|
| Rate for Payer: Blue Shield of California Commercial |
$97.77
|
| Rate for Payer: Blue Shield of California EPN |
$63.75
|
| Rate for Payer: Blue Shield of California EPN |
$320.54
|
| Rate for Payer: Cash Price |
$349.80
|
| Rate for Payer: Cash Price |
$69.56
|
| Rate for Payer: Central Health Plan Commercial |
$508.80
|
| Rate for Payer: Central Health Plan Commercial |
$101.18
|
| Rate for Payer: Cigna of CA HMO |
$88.54
|
| Rate for Payer: Cigna of CA HMO |
$445.20
|
| Rate for Payer: Cigna of CA PPO |
$88.54
|
| Rate for Payer: Cigna of CA PPO |
$445.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$50.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$254.40
|
| Rate for Payer: EPIC Health Plan Senior |
$50.59
|
| Rate for Payer: EPIC Health Plan Senior |
$254.40
|
| Rate for Payer: Galaxy Health WC |
$107.51
|
| Rate for Payer: Galaxy Health WC |
$540.60
|
| Rate for Payer: Global Benefits Group Commercial |
$381.60
|
| Rate for Payer: Global Benefits Group Commercial |
$75.89
|
| Rate for Payer: Health Management Network EPO/PPO |
$113.83
|
| Rate for Payer: Health Management Network EPO/PPO |
$572.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$84.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$424.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$242.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$48.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$78.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$393.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$127.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.30
|
| Rate for Payer: Multiplan Commercial |
$94.86
|
| Rate for Payer: Multiplan Commercial |
$477.00
|
| Rate for Payer: Networks By Design Commercial |
$63.24
|
| Rate for Payer: Networks By Design Commercial |
$318.00
|
| Rate for Payer: Prime Health Services Commercial |
$540.60
|
| Rate for Payer: Prime Health Services Commercial |
$107.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$238.69
|
| Rate for Payer: United Healthcare All Other HMO |
$232.33
|
| Rate for Payer: United Healthcare All Other HMO |
$46.20
|
| Rate for Payer: United Healthcare HMO Rider |
$45.20
|
| Rate for Payer: United Healthcare HMO Rider |
$227.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$41.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$208.29
|
|
