|
VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES
|
Facility
|
IP
|
$18,502.35
|
|
|
Service Code
|
APR-DRG 3101
|
| Min. Negotiated Rate |
$11,685.70 |
| Max. Negotiated Rate |
$18,502.35 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,685.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$13,925.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18,502.35
|
|
|
VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES
|
Facility
|
IP
|
$53,805.06
|
|
|
Service Code
|
APR-DRG 3104
|
| Min. Negotiated Rate |
$33,982.14 |
| Max. Negotiated Rate |
$53,805.06 |
| Rate for Payer: Adventist Health Medi-Cal |
$33,982.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$40,495.38
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$53,805.06
|
|
|
VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES
|
Facility
|
IP
|
$37,794.27
|
|
|
Service Code
|
APR-DRG 3103
|
| Min. Negotiated Rate |
$23,870.06 |
| Max. Negotiated Rate |
$37,794.27 |
| Rate for Payer: Adventist Health Medi-Cal |
$23,870.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$28,445.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$37,794.27
|
|
|
VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES
|
Facility
|
IP
|
$25,336.50
|
|
|
Service Code
|
APR-DRG 3102
|
| Min. Negotiated Rate |
$16,002.00 |
| Max. Negotiated Rate |
$25,336.50 |
| Rate for Payer: Adventist Health Medi-Cal |
$16,002.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$19,069.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25,336.50
|
|
|
VERTIGO AND OTHER LABYRINTH DISORDERS
|
Facility
|
IP
|
$10,371.06
|
|
|
Service Code
|
APR-DRG 1112
|
| Min. Negotiated Rate |
$6,550.14 |
| Max. Negotiated Rate |
$10,371.06 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,550.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,805.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$10,371.06
|
|
|
VERTIGO AND OTHER LABYRINTH DISORDERS
|
Facility
|
IP
|
$13,086.19
|
|
|
Service Code
|
APR-DRG 1113
|
| Min. Negotiated Rate |
$8,264.96 |
| Max. Negotiated Rate |
$13,086.19 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,264.96
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,849.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13,086.19
|
|
|
VERTIGO AND OTHER LABYRINTH DISORDERS
|
Facility
|
IP
|
$9,104.14
|
|
|
Service Code
|
APR-DRG 1111
|
| Min. Negotiated Rate |
$5,749.98 |
| Max. Negotiated Rate |
$9,104.14 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,749.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,852.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,104.14
|
|
|
VERTIGO AND OTHER LABYRINTH DISORDERS
|
Facility
|
IP
|
$23,275.99
|
|
|
Service Code
|
APR-DRG 1114
|
| Min. Negotiated Rate |
$14,700.62 |
| Max. Negotiated Rate |
$23,275.99 |
| Rate for Payer: Adventist Health Medi-Cal |
$14,700.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$17,518.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$23,275.99
|
|
|
VESTIBULOPLASTY; ANTERIOR
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 40840
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$169.70 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,613.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,613.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,976.10
|
| Rate for Payer: Blue Shield of California Commercial |
$4,407.11
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,375.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,613.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,562.92
|
| Rate for Payer: EPIC Health Plan Senior |
$8,375.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,486.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$169.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$187.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,659.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,202.61
|
| Rate for Payer: Multiplan WC |
$11,976.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Preferred Health Network WC |
$12,220.51
|
| Rate for Payer: Prime Health Services Medicare |
$8,070.72
|
| Rate for Payer: Prime Health Services WC |
$11,853.89
|
| Rate for Payer: Riverside University Health System MISP |
$8,375.28
|
| 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 |
$7,613.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Vantage Medical Group Senior |
$7,613.89
|
|
|
VESTIBULOPLASTY; COMPLEX (INCLUDING RIDGE EXTENSION, MUSCLE REPOSITIONING)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 40845
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$340.03 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,613.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,613.89
|
| 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 |
$11,976.10
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,375.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,613.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,562.92
|
| Rate for Payer: EPIC Health Plan Senior |
$8,375.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,486.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$340.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$375.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,659.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,202.61
|
| Rate for Payer: Multiplan WC |
$11,976.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Preferred Health Network WC |
$12,220.51
|
| Rate for Payer: Prime Health Services Medicare |
$8,070.72
|
| Rate for Payer: Prime Health Services WC |
$11,853.89
|
| Rate for Payer: Riverside University Health System MISP |
$8,375.28
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,613.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Vantage Medical Group Senior |
$7,613.89
|
|
|
VESTIBULOPLASTY; ENTIRE ARCH
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 40844
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$1,432.48 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,613.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,613.89
|
| 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 |
$11,976.10
|
| Rate for Payer: Blue Shield of California Commercial |
$7,080.44
|
| Rate for Payer: Blue Shield of California EPN |
$4,450.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,375.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,613.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,562.92
|
| Rate for Payer: EPIC Health Plan Senior |
$8,375.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,486.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1,432.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,582.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,659.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,202.61
|
| Rate for Payer: Multiplan WC |
$11,976.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Preferred Health Network WC |
$12,220.51
|
| Rate for Payer: Prime Health Services Medicare |
$8,070.72
|
| Rate for Payer: Prime Health Services WC |
$11,853.89
|
| Rate for Payer: Riverside University Health System MISP |
$8,375.28
|
| Rate for Payer: United Healthcare All Other HMO |
$26,788.00
|
| Rate for Payer: United Healthcare HMO Rider |
$16,872.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15,456.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$7,613.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Vantage Medical Group Senior |
$7,613.89
|
|
|
VESTIBULOPLASTY; POSTERIOR, UNILATERAL
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 40842
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$847.19 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,613.89
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7,613.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4,736.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$6,587.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$11,976.10
|
| 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 |
$11,420.83
|
| Rate for Payer: Dignity Health Medi-Cal |
$8,375.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$7,613.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$12,562.92
|
| Rate for Payer: EPIC Health Plan Senior |
$8,375.28
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$12,486.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$847.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$935.85
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$10,659.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$10,202.61
|
| Rate for Payer: Multiplan WC |
$11,976.10
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$7,613.89
|
| Rate for Payer: Preferred Health Network WC |
$12,220.51
|
| Rate for Payer: Prime Health Services Medicare |
$8,070.72
|
| Rate for Payer: Prime Health Services WC |
$11,853.89
|
| Rate for Payer: Riverside University Health System MISP |
$8,375.28
|
| 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 |
$7,613.89
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$11,420.83
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8,375.28
|
| Rate for Payer: Vantage Medical Group Senior |
$7,613.89
|
|
|
VILAZODONE 20 MG TABLET [109403]
|
Facility
|
OP
|
$1.35
|
|
|
Service Code
|
NDC 7220526130
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$1.22 |
| Rate for Payer: Adventist Health Commercial |
$0.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.74
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.65
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.79
|
| Rate for Payer: Blue Shield of California Commercial |
$0.86
|
| Rate for Payer: Blue Shield of California EPN |
$0.54
|
| Rate for Payer: Cash Price |
$0.61
|
| Rate for Payer: Central Health Plan Commercial |
$1.08
|
| Rate for Payer: Cigna of CA HMO |
$0.95
|
| Rate for Payer: Cigna of CA PPO |
$0.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.15
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.15
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.54
|
| Rate for Payer: EPIC Health Plan Senior |
$0.54
|
| Rate for Payer: Galaxy Health WC |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$0.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.95
|
| Rate for Payer: Multiplan Commercial |
$1.01
|
| Rate for Payer: Networks By Design Commercial |
$0.88
|
| Rate for Payer: Prime Health Services Commercial |
$1.15
|
| Rate for Payer: Riverside University Health System MISP |
$0.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.81
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.68
|
| Rate for Payer: United Healthcare All Other HMO |
$0.68
|
| Rate for Payer: United Healthcare HMO Rider |
$0.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.15
|
| Rate for Payer: Vantage Medical Group Senior |
$1.15
|
|
|
VILAZODONE 20 MG TABLET [109403]
|
Facility
|
OP
|
$6.13
|
|
|
Service Code
|
NDC 6050547733
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$5.52 |
| Rate for Payer: Adventist Health Commercial |
$1.23
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.72
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.60
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.97
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.57
|
| Rate for Payer: Blue Shield of California Commercial |
$3.89
|
| Rate for Payer: Blue Shield of California EPN |
$2.45
|
| Rate for Payer: Cash Price |
$2.76
|
| Rate for Payer: Central Health Plan Commercial |
$4.90
|
| Rate for Payer: Cigna of CA HMO |
$4.29
|
| Rate for Payer: Cigna of CA PPO |
$4.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2.45
|
| Rate for Payer: Galaxy Health WC |
$5.21
|
| Rate for Payer: Global Benefits Group Commercial |
$3.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.23
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$4.29
|
| Rate for Payer: Multiplan Commercial |
$4.60
|
| Rate for Payer: Networks By Design Commercial |
$3.98
|
| Rate for Payer: Prime Health Services Commercial |
$5.21
|
| Rate for Payer: Riverside University Health System MISP |
$2.45
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.06
|
| Rate for Payer: United Healthcare All Other HMO |
$3.06
|
| Rate for Payer: United Healthcare HMO Rider |
$3.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.21
|
| Rate for Payer: Vantage Medical Group Senior |
$5.21
|
|
|
VILAZODONE 20 MG TABLET [109403]
|
Facility
|
IP
|
$6.13
|
|
|
Service Code
|
NDC 6050547733
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.23 |
| Max. Negotiated Rate |
$5.52 |
| Rate for Payer: Adventist Health Commercial |
$1.23
|
| Rate for Payer: Blue Shield of California Commercial |
$4.92
|
| Rate for Payer: Blue Shield of California EPN |
$3.09
|
| Rate for Payer: Cash Price |
$2.76
|
| Rate for Payer: Central Health Plan Commercial |
$4.90
|
| Rate for Payer: Cigna of CA HMO |
$4.29
|
| Rate for Payer: Cigna of CA PPO |
$4.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$4.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.45
|
| Rate for Payer: EPIC Health Plan Senior |
$2.45
|
| Rate for Payer: Galaxy Health WC |
$5.21
|
| Rate for Payer: Global Benefits Group Commercial |
$3.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.89
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.23
|
| Rate for Payer: Multiplan Commercial |
$4.60
|
| Rate for Payer: Networks By Design Commercial |
$3.98
|
| Rate for Payer: Prime Health Services Commercial |
$5.21
|
|
|
VILAZODONE 20 MG TABLET [109403]
|
Facility
|
IP
|
$0.81
|
|
|
Service Code
|
NDC 6233223330
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$0.73 |
| Rate for Payer: Adventist Health Commercial |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.65
|
| Rate for Payer: Blue Shield of California EPN |
$0.41
|
| Rate for Payer: Cash Price |
$0.36
|
| Rate for Payer: Central Health Plan Commercial |
$0.65
|
| Rate for Payer: Cigna of CA HMO |
$0.57
|
| Rate for Payer: Cigna of CA PPO |
$0.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.32
|
| Rate for Payer: EPIC Health Plan Senior |
$0.32
|
| Rate for Payer: Galaxy Health WC |
$0.69
|
| Rate for Payer: Global Benefits Group Commercial |
$0.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.16
|
| Rate for Payer: Multiplan Commercial |
$0.61
|
| Rate for Payer: Networks By Design Commercial |
$0.53
|
| Rate for Payer: Prime Health Services Commercial |
$0.69
|
|
|
VILAZODONE 20 MG TABLET [109403]
|
Facility
|
OP
|
$0.81
|
|
|
Service Code
|
NDC 6233223330
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.16 |
| Max. Negotiated Rate |
$0.73 |
| Rate for Payer: Adventist Health Commercial |
$0.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.61
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.47
|
| Rate for Payer: Blue Shield of California Commercial |
$0.51
|
| Rate for Payer: Blue Shield of California EPN |
$0.32
|
| Rate for Payer: Cash Price |
$0.36
|
| Rate for Payer: Central Health Plan Commercial |
$0.65
|
| Rate for Payer: Cigna of CA HMO |
$0.57
|
| Rate for Payer: Cigna of CA PPO |
$0.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.69
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.32
|
| Rate for Payer: EPIC Health Plan Senior |
$0.32
|
| Rate for Payer: Galaxy Health WC |
$0.69
|
| Rate for Payer: Global Benefits Group Commercial |
$0.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.73
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.16
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.57
|
| Rate for Payer: Multiplan Commercial |
$0.61
|
| Rate for Payer: Networks By Design Commercial |
$0.53
|
| Rate for Payer: Prime Health Services Commercial |
$0.69
|
| Rate for Payer: Riverside University Health System MISP |
$0.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.41
|
| Rate for Payer: United Healthcare All Other HMO |
$0.41
|
| Rate for Payer: United Healthcare HMO Rider |
$0.41
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.69
|
| Rate for Payer: Vantage Medical Group Senior |
$0.69
|
|
|
VILAZODONE 20 MG TABLET [109403]
|
Facility
|
IP
|
$1.35
|
|
|
Service Code
|
NDC 7220526130
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$1.22 |
| Rate for Payer: Adventist Health Commercial |
$0.27
|
| Rate for Payer: Blue Shield of California Commercial |
$1.08
|
| Rate for Payer: Blue Shield of California EPN |
$0.68
|
| Rate for Payer: Cash Price |
$0.61
|
| Rate for Payer: Central Health Plan Commercial |
$1.08
|
| Rate for Payer: Cigna of CA HMO |
$0.95
|
| Rate for Payer: Cigna of CA PPO |
$0.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.54
|
| Rate for Payer: EPIC Health Plan Senior |
$0.54
|
| Rate for Payer: Galaxy Health WC |
$1.15
|
| Rate for Payer: Global Benefits Group Commercial |
$0.81
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Multiplan Commercial |
$1.01
|
| Rate for Payer: Networks By Design Commercial |
$0.88
|
| Rate for Payer: Prime Health Services Commercial |
$1.15
|
|
|
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION [8594]
|
Facility
|
IP
|
$7.35
|
|
|
Service Code
|
HCPCS J9360
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.47 |
| Max. Negotiated Rate |
$6.62 |
| Rate for Payer: Adventist Health Commercial |
$1.47
|
| Rate for Payer: Blue Shield of California Commercial |
$5.89
|
| Rate for Payer: Blue Shield of California EPN |
$3.70
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: Central Health Plan Commercial |
$5.88
|
| Rate for Payer: Cigna of CA HMO |
$5.14
|
| Rate for Payer: Cigna of CA PPO |
$5.14
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.94
|
| Rate for Payer: EPIC Health Plan Senior |
$2.94
|
| Rate for Payer: Galaxy Health WC |
$6.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.62
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.47
|
| Rate for Payer: Multiplan Commercial |
$5.51
|
| Rate for Payer: Networks By Design Commercial |
$3.67
|
| Rate for Payer: Prime Health Services Commercial |
$6.25
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.76
|
| Rate for Payer: United Healthcare All Other HMO |
$2.68
|
| Rate for Payer: United Healthcare HMO Rider |
$2.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.41
|
|
|
VINBLASTINE 1 MG/ML INTRAVENOUS SOLUTION [8594]
|
Facility
|
OP
|
$7.35
|
|
|
Service Code
|
HCPCS J9360
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.47 |
| Max. Negotiated Rate |
$31.84 |
| Rate for Payer: Adventist Health Commercial |
$1.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$31.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.25
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.51
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.95
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.92
|
| Rate for Payer: Blue Shield of California Commercial |
$7.09
|
| Rate for Payer: Blue Shield of California EPN |
$6.45
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: Cash Price |
$3.31
|
| Rate for Payer: Central Health Plan Commercial |
$5.88
|
| Rate for Payer: Cigna of CA HMO |
$5.14
|
| Rate for Payer: Cigna of CA PPO |
$5.14
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.25
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$5.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.94
|
| Rate for Payer: EPIC Health Plan Senior |
$2.94
|
| Rate for Payer: Galaxy Health WC |
$6.25
|
| Rate for Payer: Global Benefits Group Commercial |
$4.41
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.62
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$4.67
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$4.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.14
|
| Rate for Payer: Multiplan Commercial |
$5.51
|
| Rate for Payer: Networks By Design Commercial |
$3.67
|
| Rate for Payer: Prime Health Services Commercial |
$6.25
|
| Rate for Payer: Riverside University Health System MISP |
$2.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.41
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.76
|
| Rate for Payer: United Healthcare All Other HMO |
$2.68
|
| Rate for Payer: United Healthcare HMO Rider |
$2.63
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.25
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.25
|
| Rate for Payer: Vantage Medical Group Senior |
$6.25
|
|
|
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION [8597]
|
Facility
|
OP
|
$22.37
|
|
|
Service Code
|
HCPCS J9370
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.47 |
| Max. Negotiated Rate |
$82.60 |
| Rate for Payer: Adventist Health Commercial |
$4.47
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$19.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.30
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$16.78
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California EPN |
$15.27
|
| Rate for Payer: Cash Price |
$10.07
|
| Rate for Payer: Cash Price |
$10.07
|
| Rate for Payer: Central Health Plan Commercial |
$17.90
|
| Rate for Payer: Cigna of CA HMO |
$15.66
|
| Rate for Payer: Cigna of CA PPO |
$15.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$19.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$19.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$19.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.95
|
| Rate for Payer: EPIC Health Plan Senior |
$8.95
|
| Rate for Payer: Galaxy Health WC |
$19.01
|
| Rate for Payer: Global Benefits Group Commercial |
$13.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.13
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15.66
|
| Rate for Payer: Multiplan Commercial |
$16.78
|
| Rate for Payer: Networks By Design Commercial |
$11.19
|
| Rate for Payer: Prime Health Services Commercial |
$19.01
|
| Rate for Payer: Riverside University Health System MISP |
$8.95
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$13.42
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$13.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.40
|
| Rate for Payer: United Healthcare All Other HMO |
$8.17
|
| Rate for Payer: United Healthcare HMO Rider |
$8.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.33
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$19.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$19.01
|
| Rate for Payer: Vantage Medical Group Senior |
$19.01
|
|
|
VINCRISTINE 1 MG/ML INTRAVENOUS SOLUTION [8597]
|
Facility
|
IP
|
$22.37
|
|
|
Service Code
|
HCPCS J9370
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.47 |
| Max. Negotiated Rate |
$20.13 |
| Rate for Payer: Adventist Health Commercial |
$4.47
|
| Rate for Payer: Blue Shield of California Commercial |
$17.94
|
| Rate for Payer: Blue Shield of California EPN |
$11.27
|
| Rate for Payer: Cash Price |
$10.07
|
| Rate for Payer: Central Health Plan Commercial |
$17.90
|
| Rate for Payer: Cigna of CA HMO |
$15.66
|
| Rate for Payer: Cigna of CA PPO |
$15.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$15.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.95
|
| Rate for Payer: EPIC Health Plan Senior |
$8.95
|
| Rate for Payer: Galaxy Health WC |
$19.01
|
| Rate for Payer: Global Benefits Group Commercial |
$13.42
|
| Rate for Payer: Health Management Network EPO/PPO |
$20.13
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$14.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.47
|
| Rate for Payer: Multiplan Commercial |
$16.78
|
| Rate for Payer: Networks By Design Commercial |
$11.19
|
| Rate for Payer: Prime Health Services Commercial |
$19.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.40
|
| Rate for Payer: United Healthcare All Other HMO |
$8.17
|
| Rate for Payer: United Healthcare HMO Rider |
$8.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.33
|
|
|
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION [120009]
|
Facility
|
IP
|
$11.36
|
|
|
Service Code
|
HCPCS J9370
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.27 |
| Max. Negotiated Rate |
$10.22 |
| Rate for Payer: Adventist Health Commercial |
$2.27
|
| Rate for Payer: Blue Shield of California Commercial |
$9.11
|
| Rate for Payer: Blue Shield of California EPN |
$5.73
|
| Rate for Payer: Cash Price |
$5.11
|
| Rate for Payer: Central Health Plan Commercial |
$9.09
|
| Rate for Payer: Cigna of CA HMO |
$7.95
|
| Rate for Payer: Cigna of CA PPO |
$7.95
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.54
|
| Rate for Payer: EPIC Health Plan Senior |
$4.54
|
| Rate for Payer: Galaxy Health WC |
$9.66
|
| Rate for Payer: Global Benefits Group Commercial |
$6.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.27
|
| Rate for Payer: Multiplan Commercial |
$8.52
|
| Rate for Payer: Networks By Design Commercial |
$5.68
|
| Rate for Payer: Prime Health Services Commercial |
$9.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.26
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.72
|
|
|
VINCRISTINE 2 MG/2 ML INTRAVENOUS SOLUTION [120009]
|
Facility
|
OP
|
$11.36
|
|
|
Service Code
|
HCPCS J9370
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.27 |
| Max. Negotiated Rate |
$82.60 |
| Rate for Payer: Adventist Health Commercial |
$2.27
|
| Rate for Payer: Aetna of CA HMO/PPO |
$50.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.66
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.52
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$66.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$82.60
|
| Rate for Payer: Blue Shield of California Commercial |
$16.80
|
| Rate for Payer: Blue Shield of California EPN |
$15.27
|
| Rate for Payer: Cash Price |
$5.11
|
| Rate for Payer: Cash Price |
$5.11
|
| Rate for Payer: Central Health Plan Commercial |
$9.09
|
| Rate for Payer: Cigna of CA HMO |
$7.95
|
| Rate for Payer: Cigna of CA PPO |
$7.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.66
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.66
|
| Rate for Payer: Dignity Health Medicare Advantage |
$9.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$7.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.54
|
| Rate for Payer: EPIC Health Plan Senior |
$4.54
|
| Rate for Payer: Galaxy Health WC |
$9.66
|
| Rate for Payer: Global Benefits Group Commercial |
$6.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.22
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.53
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$7.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$15.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$6.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$7.95
|
| Rate for Payer: Multiplan Commercial |
$8.52
|
| Rate for Payer: Networks By Design Commercial |
$5.68
|
| Rate for Payer: Prime Health Services Commercial |
$9.66
|
| Rate for Payer: Riverside University Health System MISP |
$4.54
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.26
|
| Rate for Payer: United Healthcare All Other HMO |
$4.15
|
| Rate for Payer: United Healthcare HMO Rider |
$4.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.66
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.66
|
| Rate for Payer: Vantage Medical Group Senior |
$9.66
|
|
|
VINORELBINE 10 MG/ML INTRAVENOUS SOLUTION [14203]
|
Facility
|
IP
|
$30.00
|
|
|
Service Code
|
HCPCS J9390
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$6.00 |
| Max. Negotiated Rate |
$27.00 |
| Rate for Payer: Adventist Health Commercial |
$6.00
|
| Rate for Payer: Blue Shield of California Commercial |
$24.06
|
| Rate for Payer: Blue Shield of California EPN |
$15.12
|
| Rate for Payer: Cash Price |
$13.50
|
| Rate for Payer: Central Health Plan Commercial |
$24.00
|
| Rate for Payer: Cigna of CA HMO |
$21.00
|
| Rate for Payer: Cigna of CA PPO |
$21.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$21.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.00
|
| Rate for Payer: EPIC Health Plan Senior |
$12.00
|
| Rate for Payer: Galaxy Health WC |
$25.50
|
| Rate for Payer: Global Benefits Group Commercial |
$18.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$27.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$19.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$17.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.00
|
| Rate for Payer: Multiplan Commercial |
$22.50
|
| Rate for Payer: Networks By Design Commercial |
$15.00
|
| Rate for Payer: Prime Health Services Commercial |
$25.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$11.26
|
| Rate for Payer: United Healthcare All Other HMO |
$10.96
|
| Rate for Payer: United Healthcare HMO Rider |
$10.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.82
|
|
