|
VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$28,203.44
|
|
|
Service Code
|
MSDRG 768
|
| Min. Negotiated Rate |
$4,760.00 |
| Max. Negotiated Rate |
$28,203.44 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,203.44
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,218.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,506.22
|
| Rate for Payer: Cigna of CA HMO |
$4,760.00
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$25,873.90
|
| Rate for Payer: EPIC Health Plan Senior |
$17,249.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15,681.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21,953.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21,012.74
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15,681.15
|
| Rate for Payer: Prime Health Services Medicare |
$16,622.02
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,756.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,834.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,236.00
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC
|
Facility
|
IP
|
$19,844.53
|
|
|
Service Code
|
MSDRG 806
|
| Min. Negotiated Rate |
$5,236.00 |
| Max. Negotiated Rate |
$19,844.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,844.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,818.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$17,946.71
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$18,646.35
|
| Rate for Payer: EPIC Health Plan Senior |
$12,430.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,300.82
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15,821.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15,143.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,300.82
|
| Rate for Payer: Prime Health Services Medicare |
$11,978.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,756.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,834.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,236.00
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC
|
Facility
|
IP
|
$28,403.46
|
|
|
Service Code
|
MSDRG 805
|
| Min. Negotiated Rate |
$5,236.00 |
| Max. Negotiated Rate |
$28,403.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$28,403.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$18,347.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$25,687.12
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$26,046.87
|
| Rate for Payer: EPIC Health Plan Senior |
$17,364.58
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15,785.98
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$22,100.37
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$21,153.21
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15,785.98
|
| Rate for Payer: Prime Health Services Medicare |
$16,733.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,756.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,834.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,236.00
|
|
|
VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC
|
Facility
|
IP
|
$17,744.27
|
|
|
Service Code
|
MSDRG 807
|
| Min. Negotiated Rate |
$5,236.00 |
| Max. Negotiated Rate |
$17,744.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$17,744.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,462.07
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,047.31
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$16,830.35
|
| Rate for Payer: EPIC Health Plan Senior |
$11,220.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,200.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,280.29
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$13,668.28
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,200.21
|
| Rate for Payer: Prime Health Services Medicare |
$10,812.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,756.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,834.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,236.00
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$11,569.92
|
|
|
Service Code
|
APR-DRG 5412
|
| Min. Negotiated Rate |
$7,307.32 |
| Max. Negotiated Rate |
$11,569.92 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,307.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,707.88
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11,569.92
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$15,513.69
|
|
|
Service Code
|
APR-DRG 5413
|
| Min. Negotiated Rate |
$9,798.12 |
| Max. Negotiated Rate |
$15,513.69 |
| Rate for Payer: Adventist Health Medi-Cal |
$9,798.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11,676.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15,513.69
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$10,668.16
|
|
|
Service Code
|
APR-DRG 5411
|
| Min. Negotiated Rate |
$6,737.78 |
| Max. Negotiated Rate |
$10,668.16 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,737.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$8,029.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10,668.16
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C
|
Facility
|
IP
|
$29,326.92
|
|
|
Service Code
|
APR-DRG 5414
|
| Min. Negotiated Rate |
$18,522.26 |
| Max. Negotiated Rate |
$29,326.92 |
| Rate for Payer: Adventist Health Medi-Cal |
$18,522.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,072.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29,326.92
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC
|
Facility
|
IP
|
$26,329.53
|
|
|
Service Code
|
MSDRG 797
|
| Min. Negotiated Rate |
$5,236.00 |
| Max. Negotiated Rate |
$26,329.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,329.53
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$17,007.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,811.52
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$24,253.61
|
| Rate for Payer: EPIC Health Plan Senior |
$16,169.08
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,699.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,578.82
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,696.87
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,699.16
|
| Rate for Payer: Prime Health Services Medicare |
$15,581.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,756.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,834.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,236.00
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC
|
Facility
|
IP
|
$30,714.27
|
|
|
Service Code
|
MSDRG 796
|
| Min. Negotiated Rate |
$5,236.00 |
| Max. Negotiated Rate |
$30,714.27 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,714.27
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$19,840.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$27,776.93
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$28,044.90
|
| Rate for Payer: EPIC Health Plan Senior |
$18,696.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$16,996.91
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$23,795.67
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$22,775.86
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$16,996.91
|
| Rate for Payer: Prime Health Services Medicare |
$18,016.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,756.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,834.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,236.00
|
|
|
VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC
|
Facility
|
IP
|
$25,189.91
|
|
|
Service Code
|
MSDRG 798
|
| Min. Negotiated Rate |
$5,236.00 |
| Max. Negotiated Rate |
$25,189.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,189.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,271.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,780.89
|
| Rate for Payer: Cigna of CA PPO |
$6,000.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,268.23
|
| Rate for Payer: EPIC Health Plan Senior |
$15,512.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,101.96
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19,742.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,896.63
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,101.96
|
| Rate for Payer: Prime Health Services Medicare |
$14,948.08
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,756.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7,834.00
|
| Rate for Payer: United Healthcare HMO Rider |
$5,715.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5,236.00
|
|
|
VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS;
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 58260
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,394.44 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Prime Health Services WC |
$9,891.74
|
| Rate for Payer: Adventist Health Medi-Cal |
$6,433.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,650.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,077.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,433.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$9,993.72
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,650.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,077.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,433.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,616.08
|
| Rate for Payer: EPIC Health Plan Senior |
$7,077.39
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10,551.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,394.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,433.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,540.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,007.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8,621.55
|
| Rate for Payer: Multiplan WC |
$9,993.72
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,433.99
|
| Rate for Payer: Preferred Health Network WC |
$10,197.67
|
| Rate for Payer: Prime Health Services Medicare |
$6,820.03
|
| Rate for Payer: Riverside University Health System MISP |
$7,077.39
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,433.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,650.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,077.39
|
| Rate for Payer: Vantage Medical Group Senior |
$6,433.99
|
|
|
VAGINAL HYSTERECTOMY, FOR UTERUS 250 G OR LESS; WITH REMOVAL OF TUBE(S), AND/OR OVARY(S)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 58262
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,417.68 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,433.99
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9,650.99
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7,077.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6,433.99
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$11,461.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,933.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$9,993.72
|
| Rate for Payer: Blue Shield of California Commercial |
$3,293.23
|
| Rate for Payer: Blue Shield of California EPN |
$2,069.82
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9,650.99
|
| Rate for Payer: Dignity Health Medi-Cal |
$7,077.39
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6,433.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$10,616.08
|
| Rate for Payer: EPIC Health Plan Senior |
$7,077.39
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$10,551.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,417.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$6,433.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,566.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$9,007.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$8,621.55
|
| Rate for Payer: Multiplan WC |
$9,993.72
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$6,433.99
|
| Rate for Payer: Preferred Health Network WC |
$10,197.67
|
| Rate for Payer: Prime Health Services Medicare |
$6,820.03
|
| Rate for Payer: Prime Health Services WC |
$9,891.74
|
| Rate for Payer: Riverside University Health System MISP |
$7,077.39
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$6,433.99
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9,650.99
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7,077.39
|
| Rate for Payer: Vantage Medical Group Senior |
$6,433.99
|
|
|
VAGINECTOMY, PARTIAL REMOVAL OF VAGINAL WALL;
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 57106
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$508.11 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,163.48
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,163.48
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6,572.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9,138.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,436.87
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,579.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,163.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,869.74
|
| Rate for Payer: EPIC Health Plan Senior |
$4,579.83
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,828.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$508.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$561.28
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,828.87
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,579.06
|
| Rate for Payer: Multiplan WC |
$6,436.87
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,163.48
|
| Rate for Payer: Preferred Health Network WC |
$6,568.23
|
| Rate for Payer: Prime Health Services Medicare |
$4,413.29
|
| Rate for Payer: Prime Health Services WC |
$6,371.18
|
| Rate for Payer: Riverside University Health System MISP |
$4,579.83
|
| Rate for Payer: United Healthcare All Other HMO |
$16,122.00
|
| Rate for Payer: United Healthcare HMO Rider |
$10,165.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9,312.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,163.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,245.22
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,579.83
|
| Rate for Payer: Vantage Medical Group Senior |
$4,163.48
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
OP
|
$3.84
|
|
|
Service Code
|
NDC 6808421511
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.77 |
| Max. Negotiated Rate |
$3.46 |
| Rate for Payer: Adventist Health Commercial |
$0.77
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.33
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.23
|
| Rate for Payer: Blue Shield of California Commercial |
$2.43
|
| Rate for Payer: Blue Shield of California EPN |
$1.53
|
| Rate for Payer: Cash Price |
$1.73
|
| Rate for Payer: Central Health Plan Commercial |
$3.07
|
| Rate for Payer: Cigna of CA HMO |
$2.69
|
| Rate for Payer: Cigna of CA PPO |
$2.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.54
|
| Rate for Payer: EPIC Health Plan Senior |
$1.54
|
| Rate for Payer: Galaxy Health WC |
$3.26
|
| Rate for Payer: Global Benefits Group Commercial |
$2.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.77
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.69
|
| Rate for Payer: Multiplan Commercial |
$2.88
|
| Rate for Payer: Networks By Design Commercial |
$2.50
|
| Rate for Payer: Prime Health Services Commercial |
$3.26
|
| Rate for Payer: Riverside University Health System MISP |
$1.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.92
|
| Rate for Payer: United Healthcare All Other HMO |
$1.92
|
| Rate for Payer: United Healthcare HMO Rider |
$1.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.26
|
| Rate for Payer: Vantage Medical Group Senior |
$3.26
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
OP
|
$2.10
|
|
|
Service Code
|
NDC 5026878815
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.89 |
| Rate for Payer: Adventist Health Commercial |
$0.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.78
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.57
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.22
|
| Rate for Payer: Blue Shield of California Commercial |
$1.33
|
| Rate for Payer: Blue Shield of California EPN |
$0.84
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Central Health Plan Commercial |
$1.68
|
| Rate for Payer: Cigna of CA HMO |
$1.47
|
| Rate for Payer: Cigna of CA PPO |
$1.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.78
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.78
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Senior |
$0.84
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Global Benefits Group Commercial |
$1.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.76
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.47
|
| Rate for Payer: Multiplan Commercial |
$1.57
|
| Rate for Payer: Networks By Design Commercial |
$1.36
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
| Rate for Payer: Riverside University Health System MISP |
$0.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.26
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.05
|
| Rate for Payer: United Healthcare All Other HMO |
$1.05
|
| Rate for Payer: United Healthcare HMO Rider |
$1.05
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.78
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.78
|
| Rate for Payer: Vantage Medical Group Senior |
$1.78
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
IP
|
$0.47
|
|
|
Service Code
|
NDC 5723704290
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.42 |
| Rate for Payer: Adventist Health Commercial |
$0.09
|
| Rate for Payer: Blue Shield of California Commercial |
$0.38
|
| Rate for Payer: Blue Shield of California EPN |
$0.24
|
| Rate for Payer: Cash Price |
$0.21
|
| Rate for Payer: Central Health Plan Commercial |
$0.38
|
| Rate for Payer: Cigna of CA HMO |
$0.33
|
| Rate for Payer: Cigna of CA PPO |
$0.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.19
|
| Rate for Payer: EPIC Health Plan Senior |
$0.19
|
| Rate for Payer: Galaxy Health WC |
$0.40
|
| Rate for Payer: Global Benefits Group Commercial |
$0.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.09
|
| Rate for Payer: Multiplan Commercial |
$0.35
|
| Rate for Payer: Networks By Design Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$0.40
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
IP
|
$2.10
|
|
|
Service Code
|
NDC 5026878811
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.89 |
| Rate for Payer: Adventist Health Commercial |
$0.42
|
| Rate for Payer: Blue Shield of California Commercial |
$1.68
|
| Rate for Payer: Blue Shield of California EPN |
$1.06
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Central Health Plan Commercial |
$1.68
|
| Rate for Payer: Cigna of CA HMO |
$1.47
|
| Rate for Payer: Cigna of CA PPO |
$1.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Senior |
$0.84
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Global Benefits Group Commercial |
$1.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: Multiplan Commercial |
$1.57
|
| Rate for Payer: Networks By Design Commercial |
$1.36
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
OP
|
$0.98
|
|
|
Service Code
|
NDC 3172270430
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.88 |
| Rate for Payer: Adventist Health Commercial |
$0.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.57
|
| Rate for Payer: Blue Shield of California Commercial |
$0.62
|
| Rate for Payer: Blue Shield of California EPN |
$0.39
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Central Health Plan Commercial |
$0.78
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.39
|
| Rate for Payer: EPIC Health Plan Senior |
$0.39
|
| Rate for Payer: Galaxy Health WC |
$0.83
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.69
|
| Rate for Payer: Multiplan Commercial |
$0.74
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.83
|
| Rate for Payer: Riverside University Health System MISP |
$0.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.49
|
| Rate for Payer: United Healthcare All Other HMO |
$0.49
|
| Rate for Payer: United Healthcare HMO Rider |
$0.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.83
|
| Rate for Payer: Vantage Medical Group Senior |
$0.83
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
IP
|
$2.10
|
|
|
Service Code
|
NDC 5026878815
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.89 |
| Rate for Payer: Adventist Health Commercial |
$0.42
|
| Rate for Payer: Blue Shield of California Commercial |
$1.68
|
| Rate for Payer: Blue Shield of California EPN |
$1.06
|
| Rate for Payer: Cash Price |
$0.94
|
| Rate for Payer: Central Health Plan Commercial |
$1.68
|
| Rate for Payer: Cigna of CA HMO |
$1.47
|
| Rate for Payer: Cigna of CA PPO |
$1.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: EPIC Health Plan Senior |
$0.84
|
| Rate for Payer: Galaxy Health WC |
$1.78
|
| Rate for Payer: Global Benefits Group Commercial |
$1.26
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.89
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: Multiplan Commercial |
$1.57
|
| Rate for Payer: Networks By Design Commercial |
$1.36
|
| Rate for Payer: Prime Health Services Commercial |
$1.78
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
IP
|
$3.71
|
|
|
Service Code
|
NDC 6808421521
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$3.34 |
| Rate for Payer: Adventist Health Commercial |
$0.74
|
| Rate for Payer: Blue Shield of California Commercial |
$2.98
|
| Rate for Payer: Blue Shield of California EPN |
$1.87
|
| Rate for Payer: Cash Price |
$1.67
|
| Rate for Payer: Central Health Plan Commercial |
$2.97
|
| Rate for Payer: Cigna of CA HMO |
$2.60
|
| Rate for Payer: Cigna of CA PPO |
$2.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1.48
|
| Rate for Payer: Galaxy Health WC |
$3.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.74
|
| Rate for Payer: Multiplan Commercial |
$2.78
|
| Rate for Payer: Networks By Design Commercial |
$2.41
|
| Rate for Payer: Prime Health Services Commercial |
$3.15
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
OP
|
$3.71
|
|
|
Service Code
|
NDC 6808421521
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.74 |
| Max. Negotiated Rate |
$3.34 |
| Rate for Payer: Adventist Health Commercial |
$0.74
|
| Rate for Payer: Aetna of CA HMO/PPO |
$2.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$2.16
|
| Rate for Payer: Blue Shield of California Commercial |
$2.35
|
| Rate for Payer: Blue Shield of California EPN |
$1.48
|
| Rate for Payer: Cash Price |
$1.67
|
| Rate for Payer: Central Health Plan Commercial |
$2.97
|
| Rate for Payer: Cigna of CA HMO |
$2.60
|
| Rate for Payer: Cigna of CA PPO |
$2.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$3.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.48
|
| Rate for Payer: EPIC Health Plan Senior |
$1.48
|
| Rate for Payer: Galaxy Health WC |
$3.15
|
| Rate for Payer: Global Benefits Group Commercial |
$2.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$3.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$2.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.74
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.60
|
| Rate for Payer: Multiplan Commercial |
$2.78
|
| Rate for Payer: Networks By Design Commercial |
$2.41
|
| Rate for Payer: Prime Health Services Commercial |
$3.15
|
| Rate for Payer: Riverside University Health System MISP |
$1.48
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$2.23
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$2.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.85
|
| Rate for Payer: United Healthcare All Other HMO |
$1.85
|
| Rate for Payer: United Healthcare HMO Rider |
$1.85
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.85
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.15
|
| Rate for Payer: Vantage Medical Group Senior |
$3.15
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
IP
|
$0.47
|
|
|
Service Code
|
NDC 0378427577
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.42 |
| Rate for Payer: Adventist Health Commercial |
$0.09
|
| Rate for Payer: Blue Shield of California Commercial |
$0.38
|
| Rate for Payer: Blue Shield of California EPN |
$0.24
|
| Rate for Payer: Cash Price |
$0.21
|
| Rate for Payer: Central Health Plan Commercial |
$0.38
|
| Rate for Payer: Cigna of CA HMO |
$0.33
|
| Rate for Payer: Cigna of CA PPO |
$0.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.19
|
| Rate for Payer: EPIC Health Plan Senior |
$0.19
|
| Rate for Payer: Galaxy Health WC |
$0.40
|
| Rate for Payer: Global Benefits Group Commercial |
$0.28
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.42
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.30
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.09
|
| Rate for Payer: Multiplan Commercial |
$0.35
|
| Rate for Payer: Networks By Design Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$0.40
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
IP
|
$0.98
|
|
|
Service Code
|
NDC 6330490490
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.88 |
| Rate for Payer: Adventist Health Commercial |
$0.20
|
| Rate for Payer: Blue Shield of California Commercial |
$0.79
|
| Rate for Payer: Blue Shield of California EPN |
$0.49
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Central Health Plan Commercial |
$0.78
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.39
|
| Rate for Payer: EPIC Health Plan Senior |
$0.39
|
| Rate for Payer: Galaxy Health WC |
$0.83
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.74
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.83
|
|
|
VALACYCLOVIR 500 MG TABLET [13133]
|
Facility
|
OP
|
$0.98
|
|
|
Service Code
|
NDC 6330490490
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.88 |
| Rate for Payer: Adventist Health Commercial |
$0.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.54
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.74
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.57
|
| Rate for Payer: Blue Shield of California Commercial |
$0.62
|
| Rate for Payer: Blue Shield of California EPN |
$0.39
|
| Rate for Payer: Cash Price |
$0.44
|
| Rate for Payer: Central Health Plan Commercial |
$0.78
|
| Rate for Payer: Cigna of CA HMO |
$0.69
|
| Rate for Payer: Cigna of CA PPO |
$0.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.83
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.39
|
| Rate for Payer: EPIC Health Plan Senior |
$0.39
|
| Rate for Payer: Galaxy Health WC |
$0.83
|
| Rate for Payer: Global Benefits Group Commercial |
$0.59
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.88
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.36
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.69
|
| Rate for Payer: Multiplan Commercial |
$0.74
|
| Rate for Payer: Networks By Design Commercial |
$0.64
|
| Rate for Payer: Prime Health Services Commercial |
$0.83
|
| Rate for Payer: Riverside University Health System MISP |
$0.39
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.59
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.49
|
| Rate for Payer: United Healthcare All Other HMO |
$0.49
|
| Rate for Payer: United Healthcare HMO Rider |
$0.49
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.49
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.83
|
| Rate for Payer: Vantage Medical Group Senior |
$0.83
|
|
