|
PRAZOSIN 5 MG CAPSULE [6470]
|
Facility
IP
|
$0.41
|
|
|
Service Code
|
NDC 70954-021-20
|
| Hospital Charge Code |
1710615
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Cash Price |
$0.18
|
| Rate for Payer: Central Health Plan Commercial |
$0.33
|
| Rate for Payer: Cigna of CA HMO |
$0.29
|
| Rate for Payer: Cigna of CA PPO |
$0.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.16
|
| Rate for Payer: Galaxy Health WC |
$0.35
|
| Rate for Payer: Global Benefits Group Commercial |
$0.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.08
|
| Rate for Payer: Multiplan Commercial |
$0.31
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Prime Health Services Commercial |
$0.35
|
|
|
PRAZOSIN 5 MG CAPSULE [6470]
|
Facility
OP
|
$0.41
|
|
|
Service Code
|
NDC 70954-021-20
|
| Hospital Charge Code |
1710615
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.25
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.35
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.23
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.24
|
| Rate for Payer: BCBS Transplant Transplant |
$0.25
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California EPN |
$0.20
|
| Rate for Payer: Cash Price |
$0.18
|
| Rate for Payer: Central Health Plan Commercial |
$0.33
|
| Rate for Payer: Cigna of CA HMO |
$0.29
|
| Rate for Payer: Cigna of CA PPO |
$0.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.16
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.16
|
| Rate for Payer: Galaxy Health WC |
$0.35
|
| Rate for Payer: Global Benefits Group Commercial |
$0.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.37
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.31
|
| Rate for Payer: IEHP medi-cal |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.08
|
| Rate for Payer: Multiplan Commercial |
$0.31
|
| Rate for Payer: Networks By Design Commercial |
$0.27
|
| Rate for Payer: Prime Health Services Commercial |
$0.35
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.25
|
| Rate for Payer: Riverside University Health MISP |
$0.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.21
|
| Rate for Payer: United Healthcare All Other HMO |
$0.21
|
| Rate for Payer: United Healthcare HMO Rider |
$0.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.35
|
| Rate for Payer: Vantage Medical Group Senior |
$0.35
|
|
|
PRAZOSIN 5 MG CAPSULE [6470]
|
Facility
OP
|
$4.31
|
|
|
Service Code
|
NDC 51079-632-20
|
| Hospital Charge Code |
1710615
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.86 |
| Max. Negotiated Rate |
$3.88 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.62
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3.66
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.37
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.37
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.09
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.55
|
| Rate for Payer: BCBS Transplant Transplant |
$2.59
|
| Rate for Payer: Blue Shield of California Commercial |
$2.71
|
| Rate for Payer: Blue Shield of California EPN |
$2.11
|
| Rate for Payer: Cash Price |
$1.94
|
| Rate for Payer: Central Health Plan Commercial |
$3.45
|
| Rate for Payer: Cigna of CA HMO |
$3.02
|
| Rate for Payer: Cigna of CA PPO |
$3.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.72
|
| Rate for Payer: EPIC Health Plan Transplant |
$1.72
|
| Rate for Payer: Galaxy Health WC |
$3.66
|
| Rate for Payer: Global Benefits Group Commercial |
$2.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.88
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$3.23
|
| Rate for Payer: IEHP medi-cal |
$1.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.86
|
| Rate for Payer: Multiplan Commercial |
$3.23
|
| Rate for Payer: Networks By Design Commercial |
$2.80
|
| Rate for Payer: Prime Health Services Commercial |
$3.66
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$2.59
|
| Rate for Payer: Riverside University Health MISP |
$1.72
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.16
|
| Rate for Payer: United Healthcare All Other HMO |
$2.16
|
| Rate for Payer: United Healthcare HMO Rider |
$2.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.66
|
| Rate for Payer: Vantage Medical Group Senior |
$3.66
|
|
|
PRAZOSIN 5 MG CAPSULE [6470]
|
Facility
IP
|
$4.31
|
|
|
Service Code
|
NDC 51079-632-20
|
| Hospital Charge Code |
1710615
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.86 |
| Max. Negotiated Rate |
$3.88 |
| Rate for Payer: Blue Shield of California Commercial |
$3.23
|
| Rate for Payer: Blue Shield of California EPN |
$2.30
|
| Rate for Payer: Cash Price |
$1.94
|
| Rate for Payer: Central Health Plan Commercial |
$3.45
|
| Rate for Payer: Cigna of CA HMO |
$3.02
|
| Rate for Payer: Cigna of CA PPO |
$3.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.72
|
| Rate for Payer: Galaxy Health WC |
$3.66
|
| Rate for Payer: Global Benefits Group Commercial |
$2.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$2.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.86
|
| Rate for Payer: Multiplan Commercial |
$3.23
|
| Rate for Payer: Networks By Design Commercial |
$2.80
|
| Rate for Payer: Prime Health Services Commercial |
$3.66
|
|
|
PREDNISOLONE 15 MG/5 ML ORAL SOLUTION [11117]
|
Facility
IP
|
$0.22
|
|
|
Service Code
|
CPT J7510
|
| Hospital Charge Code |
1715149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.20 |
| Rate for Payer: Blue Shield of California Commercial |
$0.17
|
| Rate for Payer: Blue Shield of California EPN |
$0.12
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Central Health Plan Commercial |
$0.18
|
| Rate for Payer: Cigna of CA HMO |
$0.15
|
| Rate for Payer: Cigna of CA PPO |
$0.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.09
|
| Rate for Payer: Galaxy Health WC |
$0.19
|
| Rate for Payer: Global Benefits Group Commercial |
$0.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.11
|
| Rate for Payer: Prime Health Services Commercial |
$0.19
|
|
|
PREDNISOLONE 15 MG/5 ML ORAL SOLUTION [11117]
|
Facility
OP
|
$0.22
|
|
|
Service Code
|
CPT J7510
|
| Hospital Charge Code |
1715149
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$6.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.19
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.98
|
| Rate for Payer: BCBS Transplant Transplant |
$0.13
|
| Rate for Payer: Blue Shield of California Commercial |
$6.51
|
| Rate for Payer: Blue Shield of California EPN |
$5.92
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Central Health Plan Commercial |
$0.18
|
| Rate for Payer: Cigna of CA HMO |
$0.15
|
| Rate for Payer: Cigna of CA PPO |
$0.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.09
|
| Rate for Payer: Galaxy Health WC |
$0.19
|
| Rate for Payer: Global Benefits Group Commercial |
$0.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.17
|
| Rate for Payer: IEHP medi-cal |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.11
|
| Rate for Payer: Prime Health Services Commercial |
$0.19
|
| Rate for Payer: Riverside University Health MISP |
$0.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.19
|
| Rate for Payer: Vantage Medical Group Senior |
$0.19
|
|
|
PREDNISOLONE ACETATE 0.12 % EYE DROPS,SUSPENSION [27038]
|
Facility
IP
|
$38.50
|
|
|
Service Code
|
NDC 11980-174-05
|
| Hospital Charge Code |
1740164
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$34.65 |
| Rate for Payer: Blue Shield of California Commercial |
$28.88
|
| Rate for Payer: Blue Shield of California EPN |
$20.56
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Central Health Plan Commercial |
$30.80
|
| Rate for Payer: Cigna of CA HMO |
$26.95
|
| Rate for Payer: Cigna of CA PPO |
$26.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.40
|
| Rate for Payer: Galaxy Health WC |
$32.72
|
| Rate for Payer: Global Benefits Group Commercial |
$23.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.70
|
| Rate for Payer: Multiplan Commercial |
$28.88
|
| Rate for Payer: Networks By Design Commercial |
$25.02
|
| Rate for Payer: Prime Health Services Commercial |
$32.72
|
|
|
PREDNISOLONE ACETATE 0.12 % EYE DROPS,SUSPENSION [27038]
|
Facility
IP
|
$38.50
|
|
|
Service Code
|
NDC 11980-174-10
|
| Hospital Charge Code |
1740165
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$34.65 |
| Rate for Payer: Blue Shield of California Commercial |
$28.88
|
| Rate for Payer: Blue Shield of California EPN |
$20.56
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Central Health Plan Commercial |
$30.80
|
| Rate for Payer: Cigna of CA HMO |
$26.95
|
| Rate for Payer: Cigna of CA PPO |
$26.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.40
|
| Rate for Payer: Galaxy Health WC |
$32.72
|
| Rate for Payer: Global Benefits Group Commercial |
$23.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.70
|
| Rate for Payer: Multiplan Commercial |
$28.88
|
| Rate for Payer: Networks By Design Commercial |
$25.02
|
| Rate for Payer: Prime Health Services Commercial |
$32.72
|
|
|
PREDNISOLONE ACETATE 0.12 % EYE DROPS,SUSPENSION [27038]
|
Facility
OP
|
$38.50
|
|
|
Service Code
|
NDC 11980-174-05
|
| Hospital Charge Code |
1740164
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$34.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.72
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.75
|
| Rate for Payer: BCBS Transplant Transplant |
$23.10
|
| Rate for Payer: Blue Shield of California Commercial |
$24.22
|
| Rate for Payer: Blue Shield of California EPN |
$18.83
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Central Health Plan Commercial |
$30.80
|
| Rate for Payer: Cigna of CA HMO |
$26.95
|
| Rate for Payer: Cigna of CA PPO |
$26.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.40
|
| Rate for Payer: Galaxy Health WC |
$32.72
|
| Rate for Payer: Global Benefits Group Commercial |
$23.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.65
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28.88
|
| Rate for Payer: IEHP medi-cal |
$13.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.70
|
| Rate for Payer: Multiplan Commercial |
$28.88
|
| Rate for Payer: Networks By Design Commercial |
$25.02
|
| Rate for Payer: Prime Health Services Commercial |
$32.72
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.10
|
| Rate for Payer: Riverside University Health MISP |
$15.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.25
|
| Rate for Payer: United Healthcare All Other HMO |
$19.25
|
| Rate for Payer: United Healthcare HMO Rider |
$19.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.72
|
| Rate for Payer: Vantage Medical Group Senior |
$32.72
|
|
|
PREDNISOLONE ACETATE 0.12 % EYE DROPS,SUSPENSION [27038]
|
Facility
OP
|
$38.50
|
|
|
Service Code
|
NDC 11980-174-10
|
| Hospital Charge Code |
1740165
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$34.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.72
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.75
|
| Rate for Payer: BCBS Transplant Transplant |
$23.10
|
| Rate for Payer: Blue Shield of California Commercial |
$24.22
|
| Rate for Payer: Blue Shield of California EPN |
$18.83
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Central Health Plan Commercial |
$30.80
|
| Rate for Payer: Cigna of CA HMO |
$26.95
|
| Rate for Payer: Cigna of CA PPO |
$26.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.40
|
| Rate for Payer: Galaxy Health WC |
$32.72
|
| Rate for Payer: Global Benefits Group Commercial |
$23.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.65
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28.88
|
| Rate for Payer: IEHP medi-cal |
$13.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.70
|
| Rate for Payer: Multiplan Commercial |
$28.88
|
| Rate for Payer: Networks By Design Commercial |
$25.02
|
| Rate for Payer: Prime Health Services Commercial |
$32.72
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.10
|
| Rate for Payer: Riverside University Health MISP |
$15.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.25
|
| Rate for Payer: United Healthcare All Other HMO |
$19.25
|
| Rate for Payer: United Healthcare HMO Rider |
$19.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.72
|
| Rate for Payer: Vantage Medical Group Senior |
$32.72
|
|
|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION [6487]
|
Facility
OP
|
$10.62
|
|
|
Service Code
|
NDC 61314-637-05
|
| Hospital Charge Code |
1740162
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$9.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.45
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$9.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.84
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.84
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.14
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.27
|
| Rate for Payer: BCBS Transplant Transplant |
$6.37
|
| Rate for Payer: Blue Shield of California Commercial |
$6.68
|
| Rate for Payer: Blue Shield of California EPN |
$5.19
|
| Rate for Payer: Cash Price |
$4.78
|
| Rate for Payer: Central Health Plan Commercial |
$8.50
|
| Rate for Payer: Cigna of CA HMO |
$7.43
|
| Rate for Payer: Cigna of CA PPO |
$7.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.25
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.25
|
| Rate for Payer: Galaxy Health WC |
$9.03
|
| Rate for Payer: Global Benefits Group Commercial |
$6.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.56
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7.96
|
| Rate for Payer: IEHP medi-cal |
$3.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.12
|
| Rate for Payer: Multiplan Commercial |
$7.96
|
| Rate for Payer: Networks By Design Commercial |
$6.90
|
| Rate for Payer: Prime Health Services Commercial |
$9.03
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.37
|
| Rate for Payer: Riverside University Health MISP |
$4.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.37
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.31
|
| Rate for Payer: United Healthcare All Other HMO |
$5.31
|
| Rate for Payer: United Healthcare HMO Rider |
$5.31
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.03
|
| Rate for Payer: Vantage Medical Group Senior |
$9.03
|
|
|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION [6487]
|
Facility
IP
|
$10.56
|
|
|
Service Code
|
NDC 60758-119-05
|
| Hospital Charge Code |
1740162
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$9.50 |
| Rate for Payer: Blue Shield of California Commercial |
$7.92
|
| Rate for Payer: Blue Shield of California EPN |
$5.64
|
| Rate for Payer: Cash Price |
$4.75
|
| Rate for Payer: Central Health Plan Commercial |
$8.45
|
| Rate for Payer: Cigna of CA HMO |
$7.39
|
| Rate for Payer: Cigna of CA PPO |
$7.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.22
|
| Rate for Payer: Galaxy Health WC |
$8.98
|
| Rate for Payer: Global Benefits Group Commercial |
$6.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.11
|
| Rate for Payer: Multiplan Commercial |
$7.92
|
| Rate for Payer: Networks By Design Commercial |
$6.86
|
| Rate for Payer: Prime Health Services Commercial |
$8.98
|
|
|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION [6487]
|
Facility
OP
|
$38.50
|
|
|
Service Code
|
NDC 11980-180-05
|
| Hospital Charge Code |
1740162
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$34.65 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23.38
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$32.72
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$21.18
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.18
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22.75
|
| Rate for Payer: BCBS Transplant Transplant |
$23.10
|
| Rate for Payer: Blue Shield of California Commercial |
$24.22
|
| Rate for Payer: Blue Shield of California EPN |
$18.83
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Central Health Plan Commercial |
$30.80
|
| Rate for Payer: Cigna of CA HMO |
$26.95
|
| Rate for Payer: Cigna of CA PPO |
$26.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$32.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.40
|
| Rate for Payer: EPIC Health Plan Transplant |
$15.40
|
| Rate for Payer: Galaxy Health WC |
$32.72
|
| Rate for Payer: Global Benefits Group Commercial |
$23.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.65
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$28.88
|
| Rate for Payer: IEHP medi-cal |
$13.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.70
|
| Rate for Payer: Multiplan Commercial |
$28.88
|
| Rate for Payer: Networks By Design Commercial |
$25.02
|
| Rate for Payer: Prime Health Services Commercial |
$32.72
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$23.10
|
| Rate for Payer: Riverside University Health MISP |
$15.40
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$23.10
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$23.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$19.25
|
| Rate for Payer: United Healthcare All Other HMO |
$19.25
|
| Rate for Payer: United Healthcare HMO Rider |
$19.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$19.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$32.72
|
| Rate for Payer: Vantage Medical Group Senior |
$32.72
|
|
|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION [6487]
|
Facility
IP
|
$10.62
|
|
|
Service Code
|
NDC 61314-637-05
|
| Hospital Charge Code |
1740162
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.12 |
| Max. Negotiated Rate |
$9.56 |
| Rate for Payer: Blue Shield of California Commercial |
$7.96
|
| Rate for Payer: Blue Shield of California EPN |
$5.67
|
| Rate for Payer: Cash Price |
$4.78
|
| Rate for Payer: Central Health Plan Commercial |
$8.50
|
| Rate for Payer: Cigna of CA HMO |
$7.43
|
| Rate for Payer: Cigna of CA PPO |
$7.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.25
|
| Rate for Payer: Galaxy Health WC |
$9.03
|
| Rate for Payer: Global Benefits Group Commercial |
$6.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.12
|
| Rate for Payer: Multiplan Commercial |
$7.96
|
| Rate for Payer: Networks By Design Commercial |
$6.90
|
| Rate for Payer: Prime Health Services Commercial |
$9.03
|
|
|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION [6487]
|
Facility
OP
|
$10.56
|
|
|
Service Code
|
NDC 60758-119-05
|
| Hospital Charge Code |
1740162
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.11 |
| Max. Negotiated Rate |
$9.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$6.41
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.98
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.81
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.81
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6.24
|
| Rate for Payer: BCBS Transplant Transplant |
$6.34
|
| Rate for Payer: Blue Shield of California Commercial |
$6.64
|
| Rate for Payer: Blue Shield of California EPN |
$5.16
|
| Rate for Payer: Cash Price |
$4.75
|
| Rate for Payer: Central Health Plan Commercial |
$8.45
|
| Rate for Payer: Cigna of CA HMO |
$7.39
|
| Rate for Payer: Cigna of CA PPO |
$7.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.22
|
| Rate for Payer: Galaxy Health WC |
$8.98
|
| Rate for Payer: Global Benefits Group Commercial |
$6.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$7.92
|
| Rate for Payer: IEHP medi-cal |
$3.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.11
|
| Rate for Payer: Multiplan Commercial |
$7.92
|
| Rate for Payer: Networks By Design Commercial |
$6.86
|
| Rate for Payer: Prime Health Services Commercial |
$8.98
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$6.34
|
| Rate for Payer: Riverside University Health MISP |
$4.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.28
|
| Rate for Payer: United Healthcare All Other HMO |
$5.28
|
| Rate for Payer: United Healthcare HMO Rider |
$5.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.98
|
| Rate for Payer: Vantage Medical Group Senior |
$8.98
|
|
|
PREDNISOLONE ACETATE 1 % EYE DROPS,SUSPENSION [6487]
|
Facility
IP
|
$38.50
|
|
|
Service Code
|
NDC 11980-180-05
|
| Hospital Charge Code |
1740162
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.70 |
| Max. Negotiated Rate |
$34.65 |
| Rate for Payer: Blue Shield of California Commercial |
$28.88
|
| Rate for Payer: Blue Shield of California EPN |
$20.56
|
| Rate for Payer: Cash Price |
$17.33
|
| Rate for Payer: Central Health Plan Commercial |
$30.80
|
| Rate for Payer: Cigna of CA HMO |
$26.95
|
| Rate for Payer: Cigna of CA PPO |
$26.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.40
|
| Rate for Payer: Galaxy Health WC |
$32.72
|
| Rate for Payer: Global Benefits Group Commercial |
$23.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$34.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$25.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.70
|
| Rate for Payer: Multiplan Commercial |
$28.88
|
| Rate for Payer: Networks By Design Commercial |
$25.02
|
| Rate for Payer: Prime Health Services Commercial |
$32.72
|
|
|
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION [29302]
|
Facility
IP
|
$0.26
|
|
|
Service Code
|
CPT J7510
|
| Hospital Charge Code |
1715180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.23 |
| Rate for Payer: Blue Shield of California Commercial |
$0.20
|
| Rate for Payer: Blue Shield of California Commercial |
$0.11
|
| Rate for Payer: Blue Shield of California EPN |
$0.08
|
| Rate for Payer: Blue Shield of California EPN |
$0.14
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cash Price |
$0.07
|
| Rate for Payer: Central Health Plan Commercial |
$0.12
|
| Rate for Payer: Central Health Plan Commercial |
$0.21
|
| Rate for Payer: Cigna of CA HMO |
$0.18
|
| Rate for Payer: Cigna of CA HMO |
$0.11
|
| Rate for Payer: Cigna of CA PPO |
$0.18
|
| Rate for Payer: Cigna of CA PPO |
$0.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.06
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.06
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Galaxy Health WC |
$0.13
|
| Rate for Payer: Global Benefits Group Commercial |
$0.09
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.14
|
| 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 Commercial/Self Funded |
$0.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
| Rate for Payer: Networks By Design Commercial |
$0.08
|
| Rate for Payer: Networks By Design Commercial |
$0.13
|
| Rate for Payer: Prime Health Services Commercial |
$0.13
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
|
|
PREDNISOLONE SODIUM PHOSPHATE 15 MG/5 ML (3 MG/ML) ORAL SOLUTION [29302]
|
Facility
OP
|
$0.15
|
|
|
Service Code
|
CPT J7510
|
| Hospital Charge Code |
1715180
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$6.51 |
| Rate for Payer: Aetna of CA HMO/PPO |
$2.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.58
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.22
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.08
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.08
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.98
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.98
|
| Rate for Payer: BCBS Transplant Transplant |
$0.09
|
| Rate for Payer: BCBS Transplant Transplant |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$6.51
|
| Rate for Payer: Blue Shield of California Commercial |
$6.51
|
| Rate for Payer: Blue Shield of California EPN |
$5.92
|
| Rate for Payer: Blue Shield of California EPN |
$5.92
|
| Rate for Payer: Cash Price |
$0.07
|
| Rate for Payer: Cash Price |
$0.07
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Central Health Plan Commercial |
$0.21
|
| Rate for Payer: Central Health Plan Commercial |
$0.12
|
| Rate for Payer: Cigna of CA HMO |
$0.11
|
| Rate for Payer: Cigna of CA HMO |
$0.18
|
| Rate for Payer: Cigna of CA PPO |
$0.11
|
| Rate for Payer: Cigna of CA PPO |
$0.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.22
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.06
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Galaxy Health WC |
$0.13
|
| Rate for Payer: Global Benefits Group Commercial |
$0.09
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.14
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.11
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.20
|
| Rate for Payer: IEHP medi-cal |
$0.24
|
| Rate for Payer: IEHP medi-cal |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
| Rate for Payer: Networks By Design Commercial |
$0.13
|
| Rate for Payer: Networks By Design Commercial |
$0.08
|
| Rate for Payer: Prime Health Services Commercial |
$0.13
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
| Rate for Payer: Riverside University Health MISP |
$0.06
|
| Rate for Payer: Riverside University Health MISP |
$0.10
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.09
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.09
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
| Rate for Payer: United Healthcare All Other HMO |
$0.08
|
| Rate for Payer: United Healthcare All Other HMO |
$0.13
|
| Rate for Payer: United Healthcare HMO Rider |
$0.13
|
| Rate for Payer: United Healthcare HMO Rider |
$0.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.22
|
| Rate for Payer: Vantage Medical Group Senior |
$0.22
|
| Rate for Payer: Vantage Medical Group Senior |
$0.13
|
|
|
PREDNISOLONE SODIUM PHOSPHATE 1 % EYE DROPS [6489]
|
Facility
OP
|
$6.33
|
|
|
Service Code
|
NDC 24208-715-10
|
| Hospital Charge Code |
1740150
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.27 |
| Max. Negotiated Rate |
$5.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$3.84
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$5.38
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$3.48
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$3.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.06
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.74
|
| Rate for Payer: BCBS Transplant Transplant |
$3.80
|
| Rate for Payer: Blue Shield of California Commercial |
$3.98
|
| Rate for Payer: Blue Shield of California EPN |
$3.10
|
| Rate for Payer: Cash Price |
$2.85
|
| Rate for Payer: Central Health Plan Commercial |
$5.06
|
| Rate for Payer: Cigna of CA HMO |
$4.43
|
| Rate for Payer: Cigna of CA PPO |
$4.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.53
|
| Rate for Payer: Galaxy Health WC |
$5.38
|
| Rate for Payer: Global Benefits Group Commercial |
$3.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.70
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.75
|
| Rate for Payer: IEHP medi-cal |
$2.22
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.27
|
| Rate for Payer: Multiplan Commercial |
$4.75
|
| Rate for Payer: Networks By Design Commercial |
$4.11
|
| Rate for Payer: Prime Health Services Commercial |
$5.38
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$3.80
|
| Rate for Payer: Riverside University Health MISP |
$2.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.16
|
| Rate for Payer: United Healthcare All Other HMO |
$3.16
|
| Rate for Payer: United Healthcare HMO Rider |
$3.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.38
|
| Rate for Payer: Vantage Medical Group Senior |
$5.38
|
|
|
PREDNISOLONE SODIUM PHOSPHATE 1 % EYE DROPS [6489]
|
Facility
IP
|
$6.33
|
|
|
Service Code
|
NDC 24208-715-10
|
| Hospital Charge Code |
1740150
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.27 |
| Max. Negotiated Rate |
$5.70 |
| Rate for Payer: Blue Shield of California Commercial |
$4.75
|
| Rate for Payer: Blue Shield of California EPN |
$3.38
|
| Rate for Payer: Cash Price |
$2.85
|
| Rate for Payer: Central Health Plan Commercial |
$5.06
|
| Rate for Payer: Cigna of CA HMO |
$4.43
|
| Rate for Payer: Cigna of CA PPO |
$4.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.53
|
| Rate for Payer: Galaxy Health WC |
$5.38
|
| Rate for Payer: Global Benefits Group Commercial |
$3.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.27
|
| Rate for Payer: Multiplan Commercial |
$4.75
|
| Rate for Payer: Networks By Design Commercial |
$4.11
|
| Rate for Payer: Prime Health Services Commercial |
$5.38
|
|
|
PREDNISONE 10 MG TABLET [6494]
|
Facility
IP
|
$0.21
|
|
|
Service Code
|
CPT J7512
|
| Hospital Charge Code |
1710075
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.19 |
| Rate for Payer: Blue Shield of California Commercial |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.17
|
| Rate for Payer: Blue Shield of California Commercial |
$0.20
|
| Rate for Payer: Blue Shield of California EPN |
$0.14
|
| Rate for Payer: Blue Shield of California EPN |
$0.11
|
| Rate for Payer: Blue Shield of California EPN |
$0.12
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Central Health Plan Commercial |
$0.18
|
| Rate for Payer: Central Health Plan Commercial |
$0.17
|
| Rate for Payer: Central Health Plan Commercial |
$0.21
|
| Rate for Payer: Cigna of CA HMO |
$0.18
|
| Rate for Payer: Cigna of CA HMO |
$0.16
|
| Rate for Payer: Cigna of CA HMO |
$0.15
|
| Rate for Payer: Cigna of CA PPO |
$0.15
|
| Rate for Payer: Cigna of CA PPO |
$0.16
|
| Rate for Payer: Cigna of CA PPO |
$0.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.18
|
| Rate for Payer: Galaxy Health WC |
$0.20
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Global Benefits Group Commercial |
$0.14
|
| Rate for Payer: Global Benefits Group Commercial |
$0.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.16
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Networks By Design Commercial |
$0.12
|
| Rate for Payer: Networks By Design Commercial |
$0.11
|
| Rate for Payer: Networks By Design Commercial |
$0.13
|
| Rate for Payer: Prime Health Services Commercial |
$0.18
|
| Rate for Payer: Prime Health Services Commercial |
$0.20
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
|
|
PREDNISONE 10 MG TABLET [6494]
|
Facility
OP
|
$0.23
|
|
|
Service Code
|
CPT J7512
|
| Hospital Charge Code |
1710075
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.18
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.12
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.12
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.42
|
| Rate for Payer: BCBS Transplant Transplant |
$0.16
|
| Rate for Payer: BCBS Transplant Transplant |
$0.13
|
| Rate for Payer: BCBS Transplant Transplant |
$0.14
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California EPN |
$0.09
|
| Rate for Payer: Blue Shield of California EPN |
$0.09
|
| Rate for Payer: Blue Shield of California EPN |
$0.09
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Central Health Plan Commercial |
$0.18
|
| Rate for Payer: Central Health Plan Commercial |
$0.17
|
| Rate for Payer: Central Health Plan Commercial |
$0.21
|
| Rate for Payer: Cigna of CA HMO |
$0.16
|
| Rate for Payer: Cigna of CA HMO |
$0.15
|
| Rate for Payer: Cigna of CA HMO |
$0.18
|
| Rate for Payer: Cigna of CA PPO |
$0.18
|
| Rate for Payer: Cigna of CA PPO |
$0.16
|
| Rate for Payer: Cigna of CA PPO |
$0.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.18
|
| Rate for Payer: Galaxy Health WC |
$0.22
|
| Rate for Payer: Galaxy Health WC |
$0.20
|
| Rate for Payer: Global Benefits Group Commercial |
$0.14
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Global Benefits Group Commercial |
$0.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.19
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.17
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.16
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.20
|
| Rate for Payer: IEHP medi-cal |
$0.01
|
| Rate for Payer: IEHP medi-cal |
$0.01
|
| Rate for Payer: IEHP medi-cal |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.16
|
| Rate for Payer: Networks By Design Commercial |
$0.12
|
| Rate for Payer: Networks By Design Commercial |
$0.11
|
| Rate for Payer: Networks By Design Commercial |
$0.13
|
| Rate for Payer: Prime Health Services Commercial |
$0.20
|
| Rate for Payer: Prime Health Services Commercial |
$0.22
|
| Rate for Payer: Prime Health Services Commercial |
$0.18
|
| Rate for Payer: Riverside University Health MISP |
$0.09
|
| Rate for Payer: Riverside University Health MISP |
$0.10
|
| Rate for Payer: Riverside University Health MISP |
$0.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.13
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare HMO Rider |
$0.12
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.22
|
| Rate for Payer: Vantage Medical Group Senior |
$0.18
|
| Rate for Payer: Vantage Medical Group Senior |
$0.22
|
| Rate for Payer: Vantage Medical Group Senior |
$0.20
|
|
|
PREDNISONE 1 MG TABLET [6493]
|
Facility
IP
|
$0.23
|
|
|
Service Code
|
CPT J7512
|
| Hospital Charge Code |
1710450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.21 |
| Rate for Payer: Blue Shield of California Commercial |
$0.17
|
| Rate for Payer: Blue Shield of California Commercial |
$0.18
|
| Rate for Payer: Blue Shield of California Commercial |
$0.20
|
| Rate for Payer: Blue Shield of California EPN |
$0.13
|
| Rate for Payer: Blue Shield of California EPN |
$0.12
|
| Rate for Payer: Blue Shield of California EPN |
$0.14
|
| Rate for Payer: Cash Price |
$0.11
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Central Health Plan Commercial |
$0.19
|
| Rate for Payer: Central Health Plan Commercial |
$0.18
|
| Rate for Payer: Central Health Plan Commercial |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.16
|
| Rate for Payer: Cigna of CA HMO |
$0.19
|
| Rate for Payer: Cigna of CA HMO |
$0.17
|
| Rate for Payer: Cigna of CA PPO |
$0.16
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: Cigna of CA PPO |
$0.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.23
|
| Rate for Payer: Galaxy Health WC |
$0.20
|
| Rate for Payer: Galaxy Health WC |
$0.20
|
| Rate for Payer: Global Benefits Group Commercial |
$0.14
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Global Benefits Group Commercial |
$0.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Networks By Design Commercial |
$0.12
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Networks By Design Commercial |
$0.12
|
| Rate for Payer: Prime Health Services Commercial |
$0.23
|
| Rate for Payer: Prime Health Services Commercial |
$0.20
|
| Rate for Payer: Prime Health Services Commercial |
$0.20
|
|
|
PREDNISONE 1 MG TABLET [6493]
|
Facility
OP
|
$0.27
|
|
|
Service Code
|
CPT J7512
|
| Hospital Charge Code |
1710450
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.42 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.20
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.15
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.15
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.38
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.38
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.42
|
| Rate for Payer: BCBS Transplant Transplant |
$0.14
|
| Rate for Payer: BCBS Transplant Transplant |
$0.14
|
| Rate for Payer: BCBS Transplant Transplant |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California EPN |
$0.09
|
| Rate for Payer: Blue Shield of California EPN |
$0.09
|
| Rate for Payer: Blue Shield of California EPN |
$0.09
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cash Price |
$0.11
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Cash Price |
$0.11
|
| Rate for Payer: Central Health Plan Commercial |
$0.22
|
| Rate for Payer: Central Health Plan Commercial |
$0.18
|
| Rate for Payer: Central Health Plan Commercial |
$0.19
|
| Rate for Payer: Cigna of CA HMO |
$0.17
|
| Rate for Payer: Cigna of CA HMO |
$0.16
|
| Rate for Payer: Cigna of CA HMO |
$0.19
|
| Rate for Payer: Cigna of CA PPO |
$0.17
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: Cigna of CA PPO |
$0.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: Galaxy Health WC |
$0.20
|
| Rate for Payer: Galaxy Health WC |
$0.20
|
| Rate for Payer: Galaxy Health WC |
$0.23
|
| Rate for Payer: Global Benefits Group Commercial |
$0.14
|
| Rate for Payer: Global Benefits Group Commercial |
$0.14
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.21
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.18
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.20
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.17
|
| Rate for Payer: IEHP medi-cal |
$0.01
|
| Rate for Payer: IEHP medi-cal |
$0.01
|
| Rate for Payer: IEHP medi-cal |
$0.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.15
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Networks By Design Commercial |
$0.12
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Networks By Design Commercial |
$0.12
|
| Rate for Payer: Prime Health Services Commercial |
$0.20
|
| Rate for Payer: Prime Health Services Commercial |
$0.23
|
| Rate for Payer: Prime Health Services Commercial |
$0.20
|
| Rate for Payer: Riverside University Health MISP |
$0.09
|
| Rate for Payer: Riverside University Health MISP |
$0.10
|
| Rate for Payer: Riverside University Health MISP |
$0.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.14
|
| Rate for Payer: United Healthcare HMO Rider |
$0.12
|
| Rate for Payer: United Healthcare HMO Rider |
$0.14
|
| Rate for Payer: United Healthcare HMO Rider |
$0.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.23
|
| Rate for Payer: Vantage Medical Group Senior |
$0.20
|
| Rate for Payer: Vantage Medical Group Senior |
$0.20
|
| Rate for Payer: Vantage Medical Group Senior |
$0.23
|
|
|
PREDNISONE 20 MG TABLET [6496]
|
Facility
IP
|
$0.11
|
|
|
Service Code
|
CPT J7512
|
| Hospital Charge Code |
1710090
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.10 |
| Rate for Payer: Blue Shield of California Commercial |
$0.08
|
| Rate for Payer: Blue Shield of California Commercial |
$0.18
|
| Rate for Payer: Blue Shield of California Commercial |
$0.17
|
| Rate for Payer: Blue Shield of California Commercial |
$0.20
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.13
|
| Rate for Payer: Blue Shield of California EPN |
$0.06
|
| Rate for Payer: Blue Shield of California EPN |
$0.12
|
| Rate for Payer: Blue Shield of California EPN |
$0.13
|
| Rate for Payer: Blue Shield of California EPN |
$0.14
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cash Price |
$0.11
|
| Rate for Payer: Cash Price |
$0.05
|
| Rate for Payer: Cash Price |
$0.10
|
| Rate for Payer: Cash Price |
$0.11
|
| Rate for Payer: Central Health Plan Commercial |
$0.18
|
| Rate for Payer: Central Health Plan Commercial |
$0.22
|
| Rate for Payer: Central Health Plan Commercial |
$0.20
|
| Rate for Payer: Central Health Plan Commercial |
$0.09
|
| Rate for Payer: Central Health Plan Commercial |
$0.19
|
| Rate for Payer: Cigna of CA HMO |
$0.18
|
| Rate for Payer: Cigna of CA HMO |
$0.19
|
| Rate for Payer: Cigna of CA HMO |
$0.15
|
| Rate for Payer: Cigna of CA HMO |
$0.17
|
| Rate for Payer: Cigna of CA HMO |
$0.08
|
| Rate for Payer: Cigna of CA PPO |
$0.15
|
| Rate for Payer: Cigna of CA PPO |
$0.17
|
| Rate for Payer: Cigna of CA PPO |
$0.08
|
| Rate for Payer: Cigna of CA PPO |
$0.18
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.09
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.11
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.10
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.04
|
| Rate for Payer: Galaxy Health WC |
$0.20
|
| Rate for Payer: Galaxy Health WC |
$0.23
|
| Rate for Payer: Galaxy Health WC |
$0.09
|
| Rate for Payer: Galaxy Health WC |
$0.19
|
| Rate for Payer: Galaxy Health WC |
$0.21
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Global Benefits Group Commercial |
$0.14
|
| Rate for Payer: Global Benefits Group Commercial |
$0.07
|
| Rate for Payer: Global Benefits Group Commercial |
$0.13
|
| Rate for Payer: Global Benefits Group Commercial |
$0.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.10
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.16
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.19
|
| Rate for Payer: Multiplan Commercial |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.08
|
| Rate for Payer: Multiplan Commercial |
$0.18
|
| Rate for Payer: Networks By Design Commercial |
$0.13
|
| Rate for Payer: Networks By Design Commercial |
$0.06
|
| Rate for Payer: Networks By Design Commercial |
$0.11
|
| Rate for Payer: Networks By Design Commercial |
$0.12
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Prime Health Services Commercial |
$0.19
|
| Rate for Payer: Prime Health Services Commercial |
$0.21
|
| Rate for Payer: Prime Health Services Commercial |
$0.20
|
| Rate for Payer: Prime Health Services Commercial |
$0.09
|
| Rate for Payer: Prime Health Services Commercial |
$0.23
|
|
