|
CEFEPIME (MAXIPIME) 1G/10ML FROZEN SYRINGE [4081917]
|
Facility
|
IP
|
$0.59
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.53 |
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Adventist Health Commercial |
$0.11
|
| Rate for Payer: Blue Shield of California Commercial |
$0.46
|
| Rate for Payer: Blue Shield of California Commercial |
$0.42
|
| Rate for Payer: Blue Shield of California EPN |
$0.27
|
| Rate for Payer: Blue Shield of California EPN |
$0.30
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.30
|
| Rate for Payer: Central Health Plan Commercial |
$0.47
|
| Rate for Payer: Central Health Plan Commercial |
$0.43
|
| Rate for Payer: Cigna of CA HMO |
$0.38
|
| Rate for Payer: Cigna of CA HMO |
$0.41
|
| Rate for Payer: Cigna of CA PPO |
$0.38
|
| Rate for Payer: Cigna of CA PPO |
$0.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Senior |
$0.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.46
|
| Rate for Payer: Galaxy Health WC |
$0.50
|
| Rate for Payer: Global Benefits Group Commercial |
$0.35
|
| Rate for Payer: Global Benefits Group Commercial |
$0.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: Multiplan Commercial |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$0.44
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Networks By Design Commercial |
$0.30
|
| Rate for Payer: Prime Health Services Commercial |
$0.50
|
| Rate for Payer: Prime Health Services Commercial |
$0.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.22
|
| Rate for Payer: United Healthcare All Other HMO |
$0.22
|
| Rate for Payer: United Healthcare All Other HMO |
$0.20
|
| Rate for Payer: United Healthcare HMO Rider |
$0.19
|
| Rate for Payer: United Healthcare HMO Rider |
$0.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.19
|
|
|
CEFEPIME (MAXIPIME) 1G/10ML FROZEN SYRINGE [4081917]
|
Facility
|
OP
|
$0.59
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$5.61 |
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Adventist Health Commercial |
$0.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.72
|
| Rate for Payer: Blue Shield of California Commercial |
$3.37
|
| Rate for Payer: Blue Shield of California Commercial |
$3.37
|
| Rate for Payer: Blue Shield of California EPN |
$3.06
|
| Rate for Payer: Blue Shield of California EPN |
$3.06
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.30
|
| Rate for Payer: Cash Price |
$0.30
|
| Rate for Payer: Central Health Plan Commercial |
$0.47
|
| Rate for Payer: Central Health Plan Commercial |
$0.43
|
| Rate for Payer: Cigna of CA HMO |
$0.38
|
| Rate for Payer: Cigna of CA HMO |
$0.41
|
| Rate for Payer: Cigna of CA PPO |
$0.41
|
| Rate for Payer: Cigna of CA PPO |
$0.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.50
|
| Rate for Payer: Galaxy Health WC |
$0.46
|
| Rate for Payer: Global Benefits Group Commercial |
$0.35
|
| Rate for Payer: Global Benefits Group Commercial |
$0.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.20
|
| Rate for Payer: InnovAge PACE Commercial |
$0.27
|
| Rate for Payer: InnovAge PACE Commercial |
$0.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$0.44
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Networks By Design Commercial |
$0.30
|
| Rate for Payer: Prime Health Services Commercial |
$0.50
|
| Rate for Payer: Prime Health Services Commercial |
$0.46
|
| Rate for Payer: Riverside University Health System MISP |
$0.22
|
| Rate for Payer: Riverside University Health System MISP |
$0.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO |
$0.22
|
| Rate for Payer: United Healthcare All Other HMO |
$0.20
|
| Rate for Payer: United Healthcare HMO Rider |
$0.19
|
| Rate for Payer: United Healthcare HMO Rider |
$0.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.50
|
| Rate for Payer: Vantage Medical Group Senior |
$0.50
|
| Rate for Payer: Vantage Medical Group Senior |
$0.46
|
|
|
CEFEPIME (MAXIPIME) 2G/20ML FROZEN SYRINGE [4081790]
|
Facility
|
OP
|
$0.59
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$5.61 |
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Adventist Health Commercial |
$0.11
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.36
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.41
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.61
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.72
|
| Rate for Payer: Blue Shield of California Commercial |
$3.37
|
| Rate for Payer: Blue Shield of California Commercial |
$3.37
|
| Rate for Payer: Blue Shield of California EPN |
$3.06
|
| Rate for Payer: Blue Shield of California EPN |
$3.06
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.30
|
| Rate for Payer: Cash Price |
$0.30
|
| Rate for Payer: Central Health Plan Commercial |
$0.47
|
| Rate for Payer: Central Health Plan Commercial |
$0.43
|
| Rate for Payer: Cigna of CA HMO |
$0.38
|
| Rate for Payer: Cigna of CA HMO |
$0.41
|
| Rate for Payer: Cigna of CA PPO |
$0.41
|
| Rate for Payer: Cigna of CA PPO |
$0.38
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.50
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.50
|
| Rate for Payer: Galaxy Health WC |
$0.46
|
| Rate for Payer: Global Benefits Group Commercial |
$0.35
|
| Rate for Payer: Global Benefits Group Commercial |
$0.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.53
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.20
|
| Rate for Payer: InnovAge PACE Commercial |
$0.27
|
| Rate for Payer: InnovAge PACE Commercial |
$0.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.38
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$0.44
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Networks By Design Commercial |
$0.30
|
| Rate for Payer: Prime Health Services Commercial |
$0.50
|
| Rate for Payer: Prime Health Services Commercial |
$0.46
|
| Rate for Payer: Riverside University Health System MISP |
$0.22
|
| Rate for Payer: Riverside University Health System MISP |
$0.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.35
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO |
$0.22
|
| Rate for Payer: United Healthcare All Other HMO |
$0.20
|
| Rate for Payer: United Healthcare HMO Rider |
$0.19
|
| Rate for Payer: United Healthcare HMO Rider |
$0.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.46
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.50
|
| Rate for Payer: Vantage Medical Group Senior |
$0.50
|
| Rate for Payer: Vantage Medical Group Senior |
$0.46
|
|
|
CEFEPIME (MAXIPIME) 2G/20ML FROZEN SYRINGE [4081790]
|
Facility
|
IP
|
$0.59
|
|
|
Service Code
|
HCPCS J0692
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.53 |
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Adventist Health Commercial |
$0.11
|
| Rate for Payer: Blue Shield of California Commercial |
$0.46
|
| Rate for Payer: Blue Shield of California Commercial |
$0.42
|
| Rate for Payer: Blue Shield of California EPN |
$0.27
|
| Rate for Payer: Blue Shield of California EPN |
$0.30
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.30
|
| Rate for Payer: Central Health Plan Commercial |
$0.47
|
| Rate for Payer: Central Health Plan Commercial |
$0.43
|
| Rate for Payer: Cigna of CA HMO |
$0.38
|
| Rate for Payer: Cigna of CA HMO |
$0.41
|
| Rate for Payer: Cigna of CA PPO |
$0.38
|
| Rate for Payer: Cigna of CA PPO |
$0.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Senior |
$0.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.46
|
| Rate for Payer: Galaxy Health WC |
$0.50
|
| Rate for Payer: Global Benefits Group Commercial |
$0.35
|
| Rate for Payer: Global Benefits Group Commercial |
$0.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: Multiplan Commercial |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$0.44
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Networks By Design Commercial |
$0.30
|
| Rate for Payer: Prime Health Services Commercial |
$0.50
|
| Rate for Payer: Prime Health Services Commercial |
$0.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.22
|
| Rate for Payer: United Healthcare All Other HMO |
$0.22
|
| Rate for Payer: United Healthcare All Other HMO |
$0.20
|
| Rate for Payer: United Healthcare HMO Rider |
$0.19
|
| Rate for Payer: United Healthcare HMO Rider |
$0.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.19
|
|
|
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION [227170]
|
Facility
|
OP
|
$279.41
|
|
|
Service Code
|
HCPCS J0699
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$251.47 |
| Rate for Payer: Adventist Health Commercial |
$55.88
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$169.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.57
|
| Rate for Payer: Blue Shield of California Commercial |
$2.90
|
| Rate for Payer: Blue Shield of California EPN |
$2.64
|
| Rate for Payer: Cash Price |
$153.67
|
| Rate for Payer: Cash Price |
$153.67
|
| Rate for Payer: Central Health Plan Commercial |
$223.53
|
| Rate for Payer: Cigna of CA HMO |
$195.59
|
| Rate for Payer: Cigna of CA PPO |
$195.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.24
|
| Rate for Payer: EPIC Health Plan Senior |
$2.40
|
| Rate for Payer: Galaxy Health WC |
$237.50
|
| Rate for Payer: Global Benefits Group Commercial |
$167.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.47
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.40
|
| Rate for Payer: InnovAge PACE Commercial |
$3.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.22
|
| Rate for Payer: Multiplan Commercial |
$209.56
|
| Rate for Payer: Networks By Design Commercial |
$139.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.40
|
| Rate for Payer: Prime Health Services Commercial |
$237.50
|
| Rate for Payer: Prime Health Services Medicare |
$2.54
|
| Rate for Payer: Riverside University Health System MISP |
$2.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$167.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$167.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$104.86
|
| Rate for Payer: United Healthcare All Other HMO |
$102.07
|
| Rate for Payer: United Healthcare HMO Rider |
$99.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.51
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2.64
|
|
|
CEFIDEROCOL 1 GRAM INTRAVENOUS SOLUTION [227170]
|
Facility
|
IP
|
$279.41
|
|
|
Service Code
|
HCPCS J0699
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$55.88 |
| Max. Negotiated Rate |
$251.47 |
| Rate for Payer: Adventist Health Commercial |
$55.88
|
| Rate for Payer: Blue Shield of California Commercial |
$215.98
|
| Rate for Payer: Blue Shield of California EPN |
$140.82
|
| Rate for Payer: Cash Price |
$153.67
|
| Rate for Payer: Central Health Plan Commercial |
$223.53
|
| Rate for Payer: Cigna of CA HMO |
$195.59
|
| Rate for Payer: Cigna of CA PPO |
$195.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.76
|
| Rate for Payer: EPIC Health Plan Senior |
$111.76
|
| Rate for Payer: Galaxy Health WC |
$237.50
|
| Rate for Payer: Global Benefits Group Commercial |
$167.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$172.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.88
|
| Rate for Payer: Multiplan Commercial |
$209.56
|
| Rate for Payer: Networks By Design Commercial |
$139.71
|
| Rate for Payer: Prime Health Services Commercial |
$237.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$104.86
|
| Rate for Payer: United Healthcare All Other HMO |
$102.07
|
| Rate for Payer: United Healthcare HMO Rider |
$99.86
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$91.51
|
|
|
CEFIDEROCOL (FETROJA) 1 GM/100 ML IVPB [40820782]
|
Facility
|
IP
|
$279.41
|
|
|
Service Code
|
HCPCS J0699
|
| Min. Negotiated Rate |
$55.88 |
| Max. Negotiated Rate |
$251.47 |
| Rate for Payer: Adventist Health Commercial |
$55.88
|
| Rate for Payer: Cash Price |
$153.67
|
| Rate for Payer: Central Health Plan Commercial |
$223.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$111.76
|
| Rate for Payer: EPIC Health Plan Senior |
$111.76
|
| Rate for Payer: Galaxy Health WC |
$237.50
|
| Rate for Payer: Global Benefits Group Commercial |
$167.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.47
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$106.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$172.95
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.88
|
| Rate for Payer: Multiplan Commercial |
$209.56
|
| Rate for Payer: Networks By Design Commercial |
$181.62
|
| Rate for Payer: Prime Health Services Commercial |
$237.50
|
|
|
CEFIDEROCOL (FETROJA) 1 GM/100 ML IVPB [40820782]
|
Facility
|
OP
|
$279.41
|
|
|
Service Code
|
HCPCS J0699
|
| Min. Negotiated Rate |
$1.57 |
| Max. Negotiated Rate |
$251.47 |
| Rate for Payer: Adventist Health Commercial |
$55.88
|
| Rate for Payer: Adventist Health Medi-Cal |
$2.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$169.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.64
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.64
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.57
|
| Rate for Payer: Blue Shield of California Commercial |
$170.72
|
| Rate for Payer: Blue Shield of California EPN |
$111.48
|
| Rate for Payer: Cash Price |
$153.67
|
| Rate for Payer: Cash Price |
$153.67
|
| Rate for Payer: Central Health Plan Commercial |
$223.53
|
| Rate for Payer: Cigna of CA HMO |
$178.82
|
| Rate for Payer: Cigna of CA PPO |
$206.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.64
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.24
|
| Rate for Payer: EPIC Health Plan Senior |
$2.40
|
| Rate for Payer: Galaxy Health WC |
$237.50
|
| Rate for Payer: Global Benefits Group Commercial |
$167.65
|
| Rate for Payer: Health Management Network EPO/PPO |
$251.47
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.94
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$2.40
|
| Rate for Payer: InnovAge PACE Commercial |
$3.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$186.37
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$55.88
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.22
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.22
|
| Rate for Payer: Multiplan Commercial |
$209.56
|
| Rate for Payer: Networks By Design Commercial |
$181.62
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$2.40
|
| Rate for Payer: Prime Health Services Commercial |
$237.50
|
| Rate for Payer: Prime Health Services Medicare |
$2.54
|
| Rate for Payer: Riverside University Health System MISP |
$2.64
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$167.65
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$167.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$139.71
|
| Rate for Payer: United Healthcare All Other HMO |
$139.71
|
| Rate for Payer: United Healthcare HMO Rider |
$139.71
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$139.71
|
| Rate for Payer: Upland Medical Group Pediatric |
$2.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.64
|
| Rate for Payer: Vantage Medical Group Senior |
$2.64
|
|
|
CEFIXIME 200 MG/5 ML ORAL SUSPENSION [81816]
|
Facility
|
IP
|
$8.02
|
|
|
Service Code
|
NDC 65862-752-75
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$7.22 |
| Rate for Payer: Adventist Health Commercial |
$1.60
|
| Rate for Payer: Blue Shield of California Commercial |
$6.20
|
| Rate for Payer: Blue Shield of California EPN |
$4.04
|
| Rate for Payer: Cash Price |
$4.41
|
| Rate for Payer: Central Health Plan Commercial |
$6.42
|
| Rate for Payer: Cigna of CA HMO |
$5.61
|
| Rate for Payer: Cigna of CA PPO |
$5.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.21
|
| Rate for Payer: EPIC Health Plan Senior |
$3.21
|
| Rate for Payer: Galaxy Health WC |
$6.82
|
| Rate for Payer: Global Benefits Group Commercial |
$4.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.60
|
| Rate for Payer: Multiplan Commercial |
$6.01
|
| Rate for Payer: Networks By Design Commercial |
$5.21
|
| Rate for Payer: Prime Health Services Commercial |
$6.82
|
|
|
CEFIXIME 200 MG/5 ML ORAL SUSPENSION [81816]
|
Facility
|
OP
|
$8.02
|
|
|
Service Code
|
NDC 65862-752-75
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.60 |
| Max. Negotiated Rate |
$7.22 |
| Rate for Payer: Adventist Health Commercial |
$1.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.87
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.41
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.71
|
| Rate for Payer: Blue Shield of California Commercial |
$4.90
|
| Rate for Payer: Blue Shield of California EPN |
$3.20
|
| Rate for Payer: Cash Price |
$4.41
|
| Rate for Payer: Central Health Plan Commercial |
$6.42
|
| Rate for Payer: Cigna of CA HMO |
$5.61
|
| Rate for Payer: Cigna of CA PPO |
$5.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.82
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.21
|
| Rate for Payer: EPIC Health Plan Senior |
$3.21
|
| Rate for Payer: Galaxy Health WC |
$6.82
|
| Rate for Payer: Global Benefits Group Commercial |
$4.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.22
|
| Rate for Payer: InnovAge PACE Commercial |
$4.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.61
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.61
|
| Rate for Payer: Multiplan Commercial |
$6.01
|
| Rate for Payer: Networks By Design Commercial |
$5.21
|
| Rate for Payer: Prime Health Services Commercial |
$6.82
|
| Rate for Payer: Riverside University Health System MISP |
$3.21
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.01
|
| Rate for Payer: United Healthcare All Other HMO |
$4.01
|
| Rate for Payer: United Healthcare HMO Rider |
$4.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.82
|
| Rate for Payer: Vantage Medical Group Senior |
$6.82
|
|
|
CEFOXITIN 10 GRAM INTRAVENOUS SOLUTION (100 MG/ML IVPB) [9462]
|
Facility
|
IP
|
$107.99
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$21.60 |
| Max. Negotiated Rate |
$97.19 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Blue Shield of California Commercial |
$83.48
|
| Rate for Payer: Blue Shield of California EPN |
$54.43
|
| Rate for Payer: Cash Price |
$59.39
|
| Rate for Payer: Central Health Plan Commercial |
$86.39
|
| Rate for Payer: Cigna of CA HMO |
$75.59
|
| Rate for Payer: Cigna of CA PPO |
$75.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Senior |
$43.20
|
| Rate for Payer: Galaxy Health WC |
$91.79
|
| Rate for Payer: Global Benefits Group Commercial |
$64.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.19
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$41.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.60
|
| Rate for Payer: Multiplan Commercial |
$80.99
|
| Rate for Payer: Networks By Design Commercial |
$53.99
|
| Rate for Payer: Prime Health Services Commercial |
$91.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$40.53
|
| Rate for Payer: United Healthcare All Other HMO |
$39.45
|
| Rate for Payer: United Healthcare HMO Rider |
$38.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.37
|
|
|
CEFOXITIN 10 GRAM INTRAVENOUS SOLUTION (100 MG/ML IVPB) [9462]
|
Facility
|
OP
|
$107.99
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.72 |
| Max. Negotiated Rate |
$97.19 |
| Rate for Payer: Adventist Health Commercial |
$21.60
|
| Rate for Payer: Aetna of CA HMO/PPO |
$65.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$91.79
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$59.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$80.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.72
|
| Rate for Payer: Blue Shield of California Commercial |
$9.23
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Cash Price |
$59.39
|
| Rate for Payer: Cash Price |
$59.39
|
| Rate for Payer: Central Health Plan Commercial |
$86.39
|
| Rate for Payer: Cigna of CA HMO |
$75.59
|
| Rate for Payer: Cigna of CA PPO |
$75.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$91.79
|
| Rate for Payer: Dignity Health Medi-Cal |
$91.79
|
| Rate for Payer: Dignity Health Medicare Advantage |
$91.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$43.20
|
| Rate for Payer: EPIC Health Plan Senior |
$43.20
|
| Rate for Payer: Galaxy Health WC |
$91.79
|
| Rate for Payer: Global Benefits Group Commercial |
$64.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$97.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.01
|
| Rate for Payer: InnovAge PACE Commercial |
$53.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$72.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$66.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$21.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$75.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$75.59
|
| Rate for Payer: Multiplan Commercial |
$80.99
|
| Rate for Payer: Networks By Design Commercial |
$53.99
|
| Rate for Payer: Prime Health Services Commercial |
$91.79
|
| Rate for Payer: Riverside University Health System MISP |
$43.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$64.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$64.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$40.53
|
| Rate for Payer: United Healthcare All Other HMO |
$39.45
|
| Rate for Payer: United Healthcare HMO Rider |
$38.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$35.37
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$91.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$91.79
|
| Rate for Payer: Vantage Medical Group Senior |
$91.79
|
|
|
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION [9461]
|
Facility
|
IP
|
$8.39
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.68 |
| Max. Negotiated Rate |
$7.55 |
| Rate for Payer: Adventist Health Commercial |
$1.68
|
| Rate for Payer: Adventist Health Commercial |
$1.44
|
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$6.49
|
| Rate for Payer: Blue Shield of California Commercial |
$5.57
|
| Rate for Payer: Blue Shield of California Commercial |
$9.18
|
| Rate for Payer: Blue Shield of California EPN |
$5.99
|
| Rate for Payer: Blue Shield of California EPN |
$4.23
|
| Rate for Payer: Blue Shield of California EPN |
$3.63
|
| Rate for Payer: Cash Price |
$4.61
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cash Price |
$3.96
|
| Rate for Payer: Central Health Plan Commercial |
$5.76
|
| Rate for Payer: Central Health Plan Commercial |
$9.50
|
| Rate for Payer: Central Health Plan Commercial |
$6.71
|
| Rate for Payer: Cigna of CA HMO |
$5.87
|
| Rate for Payer: Cigna of CA HMO |
$8.32
|
| Rate for Payer: Cigna of CA HMO |
$5.04
|
| Rate for Payer: Cigna of CA PPO |
$5.87
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Cigna of CA PPO |
$8.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.75
|
| Rate for Payer: EPIC Health Plan Senior |
$2.88
|
| Rate for Payer: EPIC Health Plan Senior |
$4.75
|
| Rate for Payer: EPIC Health Plan Senior |
$3.36
|
| Rate for Payer: Galaxy Health WC |
$6.12
|
| Rate for Payer: Galaxy Health WC |
$10.10
|
| Rate for Payer: Galaxy Health WC |
$7.13
|
| Rate for Payer: Global Benefits Group Commercial |
$4.32
|
| Rate for Payer: Global Benefits Group Commercial |
$7.13
|
| Rate for Payer: Global Benefits Group Commercial |
$5.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.74
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.46
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: Multiplan Commercial |
$6.29
|
| Rate for Payer: Multiplan Commercial |
$5.40
|
| Rate for Payer: Multiplan Commercial |
$8.91
|
| Rate for Payer: Networks By Design Commercial |
$4.20
|
| Rate for Payer: Networks By Design Commercial |
$5.94
|
| Rate for Payer: Networks By Design Commercial |
$3.60
|
| Rate for Payer: Prime Health Services Commercial |
$6.12
|
| Rate for Payer: Prime Health Services Commercial |
$7.13
|
| Rate for Payer: Prime Health Services Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.70
|
| Rate for Payer: United Healthcare All Other HMO |
$2.63
|
| Rate for Payer: United Healthcare All Other HMO |
$4.34
|
| Rate for Payer: United Healthcare All Other HMO |
$3.06
|
| Rate for Payer: United Healthcare HMO Rider |
$4.25
|
| Rate for Payer: United Healthcare HMO Rider |
$2.57
|
| Rate for Payer: United Healthcare HMO Rider |
$3.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.89
|
|
|
CEFOXITIN 1 GRAM INTRAVENOUS SOLUTION [9461]
|
Facility
|
OP
|
$7.20
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.44 |
| Max. Negotiated Rate |
$16.93 |
| Rate for Payer: Adventist Health Commercial |
$1.44
|
| Rate for Payer: Adventist Health Commercial |
$1.68
|
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.21
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.37
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.12
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$7.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.29
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.72
|
| Rate for Payer: Blue Shield of California Commercial |
$9.23
|
| Rate for Payer: Blue Shield of California Commercial |
$9.23
|
| Rate for Payer: Blue Shield of California Commercial |
$9.23
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Cash Price |
$4.61
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cash Price |
$6.53
|
| Rate for Payer: Cash Price |
$3.96
|
| Rate for Payer: Cash Price |
$3.96
|
| Rate for Payer: Cash Price |
$4.61
|
| Rate for Payer: Central Health Plan Commercial |
$6.71
|
| Rate for Payer: Central Health Plan Commercial |
$5.76
|
| Rate for Payer: Central Health Plan Commercial |
$9.50
|
| Rate for Payer: Cigna of CA HMO |
$5.87
|
| Rate for Payer: Cigna of CA HMO |
$5.04
|
| Rate for Payer: Cigna of CA HMO |
$8.32
|
| Rate for Payer: Cigna of CA PPO |
$8.32
|
| Rate for Payer: Cigna of CA PPO |
$5.87
|
| Rate for Payer: Cigna of CA PPO |
$5.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.10
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.10
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.36
|
| Rate for Payer: EPIC Health Plan Senior |
$4.75
|
| Rate for Payer: EPIC Health Plan Senior |
$2.88
|
| Rate for Payer: EPIC Health Plan Senior |
$3.36
|
| Rate for Payer: Galaxy Health WC |
$7.13
|
| Rate for Payer: Galaxy Health WC |
$10.10
|
| Rate for Payer: Galaxy Health WC |
$6.12
|
| Rate for Payer: Global Benefits Group Commercial |
$7.13
|
| Rate for Payer: Global Benefits Group Commercial |
$5.03
|
| Rate for Payer: Global Benefits Group Commercial |
$4.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.55
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.01
|
| Rate for Payer: InnovAge PACE Commercial |
$4.20
|
| Rate for Payer: InnovAge PACE Commercial |
$3.60
|
| Rate for Payer: InnovAge PACE Commercial |
$5.94
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.46
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.87
|
| Rate for Payer: Multiplan Commercial |
$6.29
|
| Rate for Payer: Multiplan Commercial |
$8.91
|
| Rate for Payer: Multiplan Commercial |
$5.40
|
| Rate for Payer: Networks By Design Commercial |
$5.94
|
| Rate for Payer: Networks By Design Commercial |
$4.20
|
| Rate for Payer: Networks By Design Commercial |
$3.60
|
| Rate for Payer: Prime Health Services Commercial |
$6.12
|
| Rate for Payer: Prime Health Services Commercial |
$7.13
|
| Rate for Payer: Prime Health Services Commercial |
$10.10
|
| Rate for Payer: Riverside University Health System MISP |
$3.36
|
| Rate for Payer: Riverside University Health System MISP |
$2.88
|
| Rate for Payer: Riverside University Health System MISP |
$4.75
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.32
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.46
|
| Rate for Payer: United Healthcare All Other HMO |
$4.34
|
| Rate for Payer: United Healthcare All Other HMO |
$2.63
|
| Rate for Payer: United Healthcare All Other HMO |
$3.06
|
| Rate for Payer: United Healthcare HMO Rider |
$2.57
|
| Rate for Payer: United Healthcare HMO Rider |
$4.25
|
| Rate for Payer: United Healthcare HMO Rider |
$3.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.89
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.36
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$7.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.10
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.12
|
| Rate for Payer: Vantage Medical Group Senior |
$6.12
|
| Rate for Payer: Vantage Medical Group Senior |
$10.10
|
| Rate for Payer: Vantage Medical Group Senior |
$7.13
|
|
|
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION [9463]
|
Facility
|
IP
|
$9.60
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.92 |
| Max. Negotiated Rate |
$8.64 |
| Rate for Payer: Adventist Health Commercial |
$1.92
|
| Rate for Payer: Adventist Health Commercial |
$3.35
|
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Blue Shield of California Commercial |
$7.42
|
| Rate for Payer: Blue Shield of California Commercial |
$12.95
|
| Rate for Payer: Blue Shield of California Commercial |
$9.28
|
| Rate for Payer: Blue Shield of California EPN |
$6.05
|
| Rate for Payer: Blue Shield of California EPN |
$4.84
|
| Rate for Payer: Blue Shield of California EPN |
$8.44
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$9.21
|
| Rate for Payer: Central Health Plan Commercial |
$13.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Central Health Plan Commercial |
$7.68
|
| Rate for Payer: Cigna of CA HMO |
$6.72
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA HMO |
$11.72
|
| Rate for Payer: Cigna of CA PPO |
$6.72
|
| Rate for Payer: Cigna of CA PPO |
$11.72
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6.70
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3.84
|
| Rate for Payer: Galaxy Health WC |
$14.24
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$8.16
|
| Rate for Payer: Global Benefits Group Commercial |
$10.05
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.38
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.37
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: Multiplan Commercial |
$7.20
|
| Rate for Payer: Multiplan Commercial |
$12.56
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$4.80
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Networks By Design Commercial |
$8.38
|
| Rate for Payer: Prime Health Services Commercial |
$14.24
|
| Rate for Payer: Prime Health Services Commercial |
$8.16
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.29
|
| Rate for Payer: United Healthcare All Other HMO |
$6.12
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare All Other HMO |
$3.51
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare HMO Rider |
$5.99
|
| Rate for Payer: United Healthcare HMO Rider |
$3.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
|
|
CEFOXITIN 2 GRAM INTRAVENOUS SOLUTION [9463]
|
Facility
|
OP
|
$16.75
|
|
|
Service Code
|
HCPCS J0694
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.35 |
| Max. Negotiated Rate |
$16.93 |
| Rate for Payer: Adventist Health Commercial |
$3.35
|
| Rate for Payer: Adventist Health Commercial |
$1.92
|
| Rate for Payer: Adventist Health Commercial |
$2.40
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.29
|
| Rate for Payer: Aetna of CA HMO/PPO |
$10.17
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15.37
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.72
|
| Rate for Payer: Blue Shield of California Commercial |
$9.23
|
| Rate for Payer: Blue Shield of California Commercial |
$9.23
|
| Rate for Payer: Blue Shield of California Commercial |
$9.23
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Blue Shield of California EPN |
$8.39
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$6.60
|
| Rate for Payer: Cash Price |
$9.21
|
| Rate for Payer: Cash Price |
$9.21
|
| Rate for Payer: Cash Price |
$5.28
|
| Rate for Payer: Central Health Plan Commercial |
$7.68
|
| Rate for Payer: Central Health Plan Commercial |
$13.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.60
|
| Rate for Payer: Cigna of CA HMO |
$6.72
|
| Rate for Payer: Cigna of CA HMO |
$11.72
|
| Rate for Payer: Cigna of CA HMO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$8.40
|
| Rate for Payer: Cigna of CA PPO |
$6.72
|
| Rate for Payer: Cigna of CA PPO |
$11.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$14.24
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.20
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.84
|
| Rate for Payer: EPIC Health Plan Senior |
$4.80
|
| Rate for Payer: EPIC Health Plan Senior |
$6.70
|
| Rate for Payer: EPIC Health Plan Senior |
$3.84
|
| Rate for Payer: Galaxy Health WC |
$8.16
|
| Rate for Payer: Galaxy Health WC |
$10.20
|
| Rate for Payer: Galaxy Health WC |
$14.24
|
| Rate for Payer: Global Benefits Group Commercial |
$7.20
|
| Rate for Payer: Global Benefits Group Commercial |
$5.76
|
| Rate for Payer: Global Benefits Group Commercial |
$10.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$15.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.01
|
| Rate for Payer: InnovAge PACE Commercial |
$4.80
|
| Rate for Payer: InnovAge PACE Commercial |
$8.38
|
| Rate for Payer: InnovAge PACE Commercial |
$6.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$11.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$16.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.94
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$10.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$11.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.72
|
| Rate for Payer: Multiplan Commercial |
$7.20
|
| Rate for Payer: Multiplan Commercial |
$9.00
|
| Rate for Payer: Multiplan Commercial |
$12.56
|
| Rate for Payer: Networks By Design Commercial |
$6.00
|
| Rate for Payer: Networks By Design Commercial |
$4.80
|
| Rate for Payer: Networks By Design Commercial |
$8.38
|
| Rate for Payer: Prime Health Services Commercial |
$14.24
|
| Rate for Payer: Prime Health Services Commercial |
$8.16
|
| Rate for Payer: Prime Health Services Commercial |
$10.20
|
| Rate for Payer: Riverside University Health System MISP |
$3.84
|
| Rate for Payer: Riverside University Health System MISP |
$6.70
|
| Rate for Payer: Riverside University Health System MISP |
$4.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4.38
|
| Rate for Payer: United Healthcare All Other HMO |
$6.12
|
| Rate for Payer: United Healthcare All Other HMO |
$3.51
|
| Rate for Payer: United Healthcare HMO Rider |
$5.99
|
| Rate for Payer: United Healthcare HMO Rider |
$4.29
|
| Rate for Payer: United Healthcare HMO Rider |
$3.43
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.93
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$14.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.24
|
| Rate for Payer: Vantage Medical Group Senior |
$14.24
|
| Rate for Payer: Vantage Medical Group Senior |
$10.20
|
| Rate for Payer: Vantage Medical Group Senior |
$8.16
|
|
|
CEFPODOXIME 200 MG TABLET [9469]
|
Facility
|
OP
|
$4.48
|
|
|
Service Code
|
NDC 65862-096-20
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$4.03 |
| Rate for Payer: Adventist Health Commercial |
$0.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.81
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.46
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.63
|
| Rate for Payer: Blue Shield of California Commercial |
$2.74
|
| Rate for Payer: Blue Shield of California EPN |
$1.79
|
| Rate for Payer: Cash Price |
$2.46
|
| Rate for Payer: Central Health Plan Commercial |
$3.58
|
| Rate for Payer: Cigna of CA HMO |
$3.14
|
| Rate for Payer: Cigna of CA PPO |
$3.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.81
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.81
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.81
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1.79
|
| Rate for Payer: Galaxy Health WC |
$3.81
|
| Rate for Payer: Global Benefits Group Commercial |
$2.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.03
|
| Rate for Payer: InnovAge PACE Commercial |
$2.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.14
|
| Rate for Payer: Multiplan Commercial |
$3.36
|
| Rate for Payer: Networks By Design Commercial |
$2.91
|
| Rate for Payer: Prime Health Services Commercial |
$3.81
|
| Rate for Payer: Riverside University Health System MISP |
$1.79
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.69
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.24
|
| Rate for Payer: United Healthcare All Other HMO |
$2.24
|
| Rate for Payer: United Healthcare HMO Rider |
$2.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.81
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.81
|
| Rate for Payer: Vantage Medical Group Senior |
$3.81
|
|
|
CEFPODOXIME 200 MG TABLET [9469]
|
Facility
|
IP
|
$4.48
|
|
|
Service Code
|
NDC 65862-096-20
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.90 |
| Max. Negotiated Rate |
$4.03 |
| Rate for Payer: Adventist Health Commercial |
$0.90
|
| Rate for Payer: Blue Shield of California Commercial |
$3.46
|
| Rate for Payer: Blue Shield of California EPN |
$2.26
|
| Rate for Payer: Cash Price |
$2.46
|
| Rate for Payer: Central Health Plan Commercial |
$3.58
|
| Rate for Payer: Cigna of CA HMO |
$3.14
|
| Rate for Payer: Cigna of CA PPO |
$3.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.79
|
| Rate for Payer: EPIC Health Plan Senior |
$1.79
|
| Rate for Payer: Galaxy Health WC |
$3.81
|
| Rate for Payer: Global Benefits Group Commercial |
$2.69
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.99
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.90
|
| Rate for Payer: Multiplan Commercial |
$3.36
|
| Rate for Payer: Networks By Design Commercial |
$2.91
|
| Rate for Payer: Prime Health Services Commercial |
$3.81
|
|
|
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION [107670]
|
Facility
|
OP
|
$308.95
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$278.06 |
| Rate for Payer: Adventist Health Commercial |
$61.79
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$187.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.62
|
| Rate for Payer: Blue Shield of California Commercial |
$6.74
|
| Rate for Payer: Blue Shield of California EPN |
$6.13
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Central Health Plan Commercial |
$247.16
|
| Rate for Payer: Cigna of CA HMO |
$216.26
|
| Rate for Payer: Cigna of CA PPO |
$216.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4.24
|
| Rate for Payer: Galaxy Health WC |
$262.61
|
| Rate for Payer: Global Benefits Group Commercial |
$185.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$278.06
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.24
|
| Rate for Payer: InnovAge PACE Commercial |
$6.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$206.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.69
|
| Rate for Payer: Multiplan Commercial |
$231.71
|
| Rate for Payer: Networks By Design Commercial |
$154.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.24
|
| Rate for Payer: Prime Health Services Commercial |
$262.61
|
| Rate for Payer: Prime Health Services Medicare |
$4.50
|
| Rate for Payer: Riverside University Health System MISP |
$4.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$185.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$185.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.95
|
| Rate for Payer: United Healthcare All Other HMO |
$112.86
|
| Rate for Payer: United Healthcare HMO Rider |
$110.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.67
|
| Rate for Payer: Vantage Medical Group Senior |
$4.67
|
|
|
CEFTAROLINE FOSAMIL 400 MG INTRAVENOUS SOLUTION [107670]
|
Facility
|
IP
|
$308.95
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.79 |
| Max. Negotiated Rate |
$278.06 |
| Rate for Payer: Adventist Health Commercial |
$61.79
|
| Rate for Payer: Blue Shield of California Commercial |
$238.82
|
| Rate for Payer: Blue Shield of California EPN |
$155.71
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Central Health Plan Commercial |
$247.16
|
| Rate for Payer: Cigna of CA HMO |
$216.26
|
| Rate for Payer: Cigna of CA PPO |
$216.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.58
|
| Rate for Payer: EPIC Health Plan Senior |
$123.58
|
| Rate for Payer: Galaxy Health WC |
$262.61
|
| Rate for Payer: Global Benefits Group Commercial |
$185.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$278.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$206.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$191.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.79
|
| Rate for Payer: Multiplan Commercial |
$231.71
|
| Rate for Payer: Networks By Design Commercial |
$154.47
|
| Rate for Payer: Prime Health Services Commercial |
$262.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.95
|
| Rate for Payer: United Healthcare All Other HMO |
$112.86
|
| Rate for Payer: United Healthcare HMO Rider |
$110.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.18
|
|
|
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION [107671]
|
Facility
|
OP
|
$308.95
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.62 |
| Max. Negotiated Rate |
$278.06 |
| Rate for Payer: Adventist Health Commercial |
$61.79
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.24
|
| Rate for Payer: Aetna of CA HMO/PPO |
$187.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.62
|
| Rate for Payer: Blue Shield of California Commercial |
$6.74
|
| Rate for Payer: Blue Shield of California EPN |
$6.13
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Central Health Plan Commercial |
$247.16
|
| Rate for Payer: Cigna of CA HMO |
$216.26
|
| Rate for Payer: Cigna of CA PPO |
$216.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.73
|
| Rate for Payer: EPIC Health Plan Senior |
$4.24
|
| Rate for Payer: Galaxy Health WC |
$262.61
|
| Rate for Payer: Global Benefits Group Commercial |
$185.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$278.06
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.24
|
| Rate for Payer: InnovAge PACE Commercial |
$6.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$206.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.50
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.69
|
| Rate for Payer: Multiplan Commercial |
$231.71
|
| Rate for Payer: Networks By Design Commercial |
$154.47
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.24
|
| Rate for Payer: Prime Health Services Commercial |
$262.61
|
| Rate for Payer: Prime Health Services Medicare |
$4.50
|
| Rate for Payer: Riverside University Health System MISP |
$4.67
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$185.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$185.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.95
|
| Rate for Payer: United Healthcare All Other HMO |
$112.86
|
| Rate for Payer: United Healthcare HMO Rider |
$110.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.18
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.67
|
| Rate for Payer: Vantage Medical Group Senior |
$4.67
|
|
|
CEFTAROLINE FOSAMIL 600 MG INTRAVENOUS SOLUTION [107671]
|
Facility
|
IP
|
$308.95
|
|
|
Service Code
|
HCPCS J0712
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$61.79 |
| Max. Negotiated Rate |
$278.06 |
| Rate for Payer: Adventist Health Commercial |
$61.79
|
| Rate for Payer: Blue Shield of California Commercial |
$238.82
|
| Rate for Payer: Blue Shield of California EPN |
$155.71
|
| Rate for Payer: Cash Price |
$169.92
|
| Rate for Payer: Central Health Plan Commercial |
$247.16
|
| Rate for Payer: Cigna of CA HMO |
$216.26
|
| Rate for Payer: Cigna of CA PPO |
$216.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$123.58
|
| Rate for Payer: EPIC Health Plan Senior |
$123.58
|
| Rate for Payer: Galaxy Health WC |
$262.61
|
| Rate for Payer: Global Benefits Group Commercial |
$185.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$278.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$206.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$191.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$61.79
|
| Rate for Payer: Multiplan Commercial |
$231.71
|
| Rate for Payer: Networks By Design Commercial |
$154.47
|
| Rate for Payer: Prime Health Services Commercial |
$262.61
|
| Rate for Payer: United Healthcare All Other Commercial |
$115.95
|
| Rate for Payer: United Healthcare All Other HMO |
$112.86
|
| Rate for Payer: United Healthcare HMO Rider |
$110.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$101.18
|
|
|
CEFTAZIDIME 10 MG/ML SERIAL DILUTION FOR MIXTURES [4080886]
|
Facility
|
IP
|
$5.12
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$4.61 |
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Blue Shield of California Commercial |
$3.96
|
| Rate for Payer: Blue Shield of California EPN |
$2.58
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Central Health Plan Commercial |
$4.10
|
| Rate for Payer: Cigna of CA HMO |
$3.58
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.05
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| Rate for Payer: Galaxy Health WC |
$4.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.02
|
| Rate for Payer: Multiplan Commercial |
$3.84
|
| Rate for Payer: Networks By Design Commercial |
$2.56
|
| Rate for Payer: Prime Health Services Commercial |
$4.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.87
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.68
|
|
|
CEFTAZIDIME 10 MG/ML SERIAL DILUTION FOR MIXTURES [4080886]
|
Facility
|
OP
|
$5.12
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.02 |
| Max. Negotiated Rate |
$4.69 |
| Rate for Payer: Adventist Health Commercial |
$1.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.82
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$2.82
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Cash Price |
$2.81
|
| Rate for Payer: Central Health Plan Commercial |
$4.10
|
| Rate for Payer: Cigna of CA HMO |
$3.58
|
| Rate for Payer: Cigna of CA PPO |
$3.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.35
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.35
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.05
|
| Rate for Payer: EPIC Health Plan Senior |
$2.05
|
| Rate for Payer: Galaxy Health WC |
$4.35
|
| Rate for Payer: Global Benefits Group Commercial |
$3.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.60
|
| Rate for Payer: InnovAge PACE Commercial |
$2.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.58
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.58
|
| Rate for Payer: Multiplan Commercial |
$3.84
|
| Rate for Payer: Networks By Design Commercial |
$2.56
|
| Rate for Payer: Prime Health Services Commercial |
$4.35
|
| Rate for Payer: Riverside University Health System MISP |
$2.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.87
|
| Rate for Payer: United Healthcare HMO Rider |
$1.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.35
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.35
|
| Rate for Payer: Vantage Medical Group Senior |
$4.35
|
|
|
CEFTAZIDIME 1 GRAM INTRAVENOUS SOLUTION [27290]
|
Facility
|
OP
|
$7.14
|
|
|
Service Code
|
HCPCS J0713
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.43 |
| Max. Negotiated Rate |
$6.43 |
| Rate for Payer: Adventist Health Commercial |
$1.43
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.93
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.69
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.44
|
| Rate for Payer: Blue Shield of California Commercial |
$2.82
|
| Rate for Payer: Blue Shield of California EPN |
$2.56
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Cash Price |
$3.93
|
| Rate for Payer: Central Health Plan Commercial |
$5.71
|
| Rate for Payer: Cigna of CA HMO |
$5.00
|
| Rate for Payer: Cigna of CA PPO |
$5.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.86
|
| Rate for Payer: EPIC Health Plan Senior |
$2.86
|
| Rate for Payer: Galaxy Health WC |
$6.07
|
| Rate for Payer: Global Benefits Group Commercial |
$4.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.60
|
| Rate for Payer: InnovAge PACE Commercial |
$3.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.00
|
| Rate for Payer: Multiplan Commercial |
$5.36
|
| Rate for Payer: Networks By Design Commercial |
$3.57
|
| Rate for Payer: Prime Health Services Commercial |
$6.07
|
| Rate for Payer: Riverside University Health System MISP |
$2.86
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.28
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.68
|
| Rate for Payer: United Healthcare All Other HMO |
$2.61
|
| Rate for Payer: United Healthcare HMO Rider |
$2.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.07
|
| Rate for Payer: Vantage Medical Group Senior |
$6.07
|
|
