|
DENOSUMAB 120 MG/1.7 ML (70 MG/ML) SUBCUTANEOUS SOLUTION [106804]
|
Facility
|
IP
|
$2,508.16
|
|
|
Service Code
|
HCPCS J0897
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$501.63 |
| Max. Negotiated Rate |
$2,257.34 |
| Rate for Payer: Adventist Health Commercial |
$501.63
|
| Rate for Payer: Blue Shield of California Commercial |
$2,011.54
|
| Rate for Payer: Blue Shield of California EPN |
$1,264.11
|
| Rate for Payer: Cash Price |
$1,128.67
|
| Rate for Payer: Central Health Plan Commercial |
$2,006.53
|
| Rate for Payer: Cigna of CA HMO |
$1,755.71
|
| Rate for Payer: Cigna of CA PPO |
$1,755.71
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,755.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,003.26
|
| Rate for Payer: EPIC Health Plan Senior |
$1,003.26
|
| Rate for Payer: Galaxy Health WC |
$2,131.94
|
| Rate for Payer: Global Benefits Group Commercial |
$1,504.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,257.34
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,592.68
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,479.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$501.63
|
| Rate for Payer: Multiplan Commercial |
$1,881.12
|
| Rate for Payer: Networks By Design Commercial |
$1,254.08
|
| Rate for Payer: Prime Health Services Commercial |
$2,131.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$941.31
|
| Rate for Payer: United Healthcare All Other HMO |
$916.23
|
| Rate for Payer: United Healthcare HMO Rider |
$896.42
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$821.42
|
|
|
DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE [105502]
|
Facility
|
IP
|
$2,318.03
|
|
|
Service Code
|
HCPCS J0897
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$463.61 |
| Max. Negotiated Rate |
$2,086.23 |
| Rate for Payer: Adventist Health Commercial |
$463.61
|
| Rate for Payer: Blue Shield of California Commercial |
$1,859.06
|
| Rate for Payer: Blue Shield of California EPN |
$1,168.29
|
| Rate for Payer: Cash Price |
$1,043.11
|
| Rate for Payer: Central Health Plan Commercial |
$1,854.42
|
| Rate for Payer: Cigna of CA HMO |
$1,622.62
|
| Rate for Payer: Cigna of CA PPO |
$1,622.62
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,622.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$927.21
|
| Rate for Payer: EPIC Health Plan Senior |
$927.21
|
| Rate for Payer: Galaxy Health WC |
$1,970.33
|
| Rate for Payer: Global Benefits Group Commercial |
$1,390.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,086.23
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,471.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,367.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$463.61
|
| Rate for Payer: Multiplan Commercial |
$1,738.52
|
| Rate for Payer: Networks By Design Commercial |
$1,159.02
|
| Rate for Payer: Prime Health Services Commercial |
$1,970.33
|
| Rate for Payer: United Healthcare All Other Commercial |
$869.96
|
| Rate for Payer: United Healthcare All Other HMO |
$846.78
|
| Rate for Payer: United Healthcare HMO Rider |
$828.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$759.15
|
|
|
DENOSUMAB 60 MG/ML SUBCUTANEOUS SYRINGE [105502]
|
Facility
|
OP
|
$2,318.03
|
|
|
Service Code
|
HCPCS J0897
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$30.10 |
| Max. Negotiated Rate |
$2,086.23 |
| Rate for Payer: Adventist Health Commercial |
$463.61
|
| Rate for Payer: Adventist Health Medi-Cal |
$30.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$172.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.62
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$33.11
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$33.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$36.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$45.94
|
| Rate for Payer: Blue Shield of California Commercial |
$38.24
|
| Rate for Payer: Blue Shield of California EPN |
$34.76
|
| Rate for Payer: Cash Price |
$1,043.11
|
| Rate for Payer: Cash Price |
$1,043.11
|
| Rate for Payer: Central Health Plan Commercial |
$1,854.42
|
| Rate for Payer: Cigna of CA HMO |
$1,622.62
|
| Rate for Payer: Cigna of CA PPO |
$1,622.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.62
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.11
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,622.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$49.66
|
| Rate for Payer: EPIC Health Plan Senior |
$33.11
|
| Rate for Payer: Galaxy Health WC |
$1,970.33
|
| Rate for Payer: Global Benefits Group Commercial |
$1,390.82
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,086.23
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$49.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$30.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30.10
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,471.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$64.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$42.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$463.61
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$40.33
|
| Rate for Payer: Multiplan Commercial |
$1,738.52
|
| Rate for Payer: Networks By Design Commercial |
$1,159.02
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$30.10
|
| Rate for Payer: Prime Health Services Commercial |
$1,970.33
|
| Rate for Payer: Prime Health Services Medicare |
$31.91
|
| Rate for Payer: Riverside University Health System MISP |
$33.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,390.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,390.82
|
| Rate for Payer: United Healthcare All Other Commercial |
$869.96
|
| Rate for Payer: United Healthcare All Other HMO |
$846.78
|
| Rate for Payer: United Healthcare HMO Rider |
$828.46
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$759.15
|
| Rate for Payer: Upland Medical Group Pediatric |
$30.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.62
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.11
|
| Rate for Payer: Vantage Medical Group Senior |
$33.11
|
|
|
DENOSUMAB-BBDZ 60 MG/ML SUBCUTANEOUS SYRINGE [245944]
|
Facility
|
OP
|
$1,924.96
|
|
|
Service Code
|
HCPCS Q5136
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.66 |
| Max. Negotiated Rate |
$1,732.46 |
| Rate for Payer: Adventist Health Commercial |
$384.99
|
| Rate for Payer: Adventist Health Medi-Cal |
$27.67
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,169.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$41.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.67
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$52.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$65.95
|
| Rate for Payer: Blue Shield of California Commercial |
$1,220.42
|
| Rate for Payer: Blue Shield of California EPN |
$768.06
|
| Rate for Payer: Cash Price |
$866.23
|
| Rate for Payer: Cash Price |
$866.23
|
| Rate for Payer: Central Health Plan Commercial |
$1,539.97
|
| Rate for Payer: Cigna of CA HMO |
$1,347.47
|
| Rate for Payer: Cigna of CA PPO |
$1,347.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$41.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.44
|
| Rate for Payer: Dignity Health Medicare Advantage |
$27.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,347.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.66
|
| Rate for Payer: EPIC Health Plan Senior |
$30.44
|
| Rate for Payer: Galaxy Health WC |
$1,636.22
|
| Rate for Payer: Global Benefits Group Commercial |
$1,154.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,732.46
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$45.38
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$27.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,222.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$62.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$38.74
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$384.99
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$37.08
|
| Rate for Payer: Multiplan Commercial |
$1,443.72
|
| Rate for Payer: Networks By Design Commercial |
$962.48
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$27.67
|
| Rate for Payer: Prime Health Services Commercial |
$1,636.22
|
| Rate for Payer: Prime Health Services Medicare |
$29.33
|
| Rate for Payer: Riverside University Health System MISP |
$30.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,154.98
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,154.98
|
| Rate for Payer: United Healthcare All Other Commercial |
$722.44
|
| Rate for Payer: United Healthcare All Other HMO |
$703.19
|
| Rate for Payer: United Healthcare HMO Rider |
$687.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$630.42
|
| Rate for Payer: Upland Medical Group Pediatric |
$27.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$41.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.44
|
| Rate for Payer: Vantage Medical Group Senior |
$27.67
|
|
|
DENOSUMAB-BBDZ 60 MG/ML SUBCUTANEOUS SYRINGE [245944]
|
Facility
|
IP
|
$1,924.96
|
|
|
Service Code
|
HCPCS Q5136
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$384.99 |
| Max. Negotiated Rate |
$1,732.46 |
| Rate for Payer: Adventist Health Commercial |
$384.99
|
| Rate for Payer: Blue Shield of California Commercial |
$1,543.82
|
| Rate for Payer: Blue Shield of California EPN |
$970.18
|
| Rate for Payer: Cash Price |
$866.23
|
| Rate for Payer: Central Health Plan Commercial |
$1,539.97
|
| Rate for Payer: Cigna of CA HMO |
$1,347.47
|
| Rate for Payer: Cigna of CA PPO |
$1,347.47
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,347.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$769.98
|
| Rate for Payer: EPIC Health Plan Senior |
$769.98
|
| Rate for Payer: Galaxy Health WC |
$1,636.22
|
| Rate for Payer: Global Benefits Group Commercial |
$1,154.98
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,732.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,222.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,135.73
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$384.99
|
| Rate for Payer: Multiplan Commercial |
$1,443.72
|
| Rate for Payer: Networks By Design Commercial |
$962.48
|
| Rate for Payer: Prime Health Services Commercial |
$1,636.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$722.44
|
| Rate for Payer: United Healthcare All Other HMO |
$703.19
|
| Rate for Payer: United Healthcare HMO Rider |
$687.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$630.42
|
|
|
DENOSUMAB-BMWO 60 MG/ML SUBCUTANEOUS SYRINGE [246286]
|
Facility
|
OP
|
$2,137.99
|
|
|
Service Code
|
HCPCS Q5157
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.98 |
| Max. Negotiated Rate |
$1,924.19 |
| Rate for Payer: Adventist Health Commercial |
$427.60
|
| Rate for Payer: Adventist Health Medi-Cal |
$25.98
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1,298.40
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$38.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$28.58
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$25.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$56.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$70.43
|
| Rate for Payer: Blue Shield of California Commercial |
$1,355.49
|
| Rate for Payer: Blue Shield of California EPN |
$853.06
|
| Rate for Payer: Cash Price |
$962.10
|
| Rate for Payer: Cash Price |
$962.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,710.39
|
| Rate for Payer: Cigna of CA HMO |
$1,496.59
|
| Rate for Payer: Cigna of CA PPO |
$1,496.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$38.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$25.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,496.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$42.87
|
| Rate for Payer: EPIC Health Plan Senior |
$28.58
|
| Rate for Payer: Galaxy Health WC |
$1,817.29
|
| Rate for Payer: Global Benefits Group Commercial |
$1,282.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,924.19
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$42.61
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25.98
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25.98
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,357.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$62.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$427.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$34.81
|
| Rate for Payer: Multiplan Commercial |
$1,603.49
|
| Rate for Payer: Networks By Design Commercial |
$1,068.99
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$25.98
|
| Rate for Payer: Prime Health Services Commercial |
$1,817.29
|
| Rate for Payer: Prime Health Services Medicare |
$27.54
|
| Rate for Payer: Riverside University Health System MISP |
$28.58
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1,282.79
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1,282.79
|
| Rate for Payer: United Healthcare All Other Commercial |
$802.39
|
| Rate for Payer: United Healthcare All Other HMO |
$781.01
|
| Rate for Payer: United Healthcare HMO Rider |
$764.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$700.19
|
| Rate for Payer: Upland Medical Group Pediatric |
$25.98
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$38.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.58
|
| Rate for Payer: Vantage Medical Group Senior |
$25.98
|
|
|
DENOSUMAB-BMWO 60 MG/ML SUBCUTANEOUS SYRINGE [246286]
|
Facility
|
IP
|
$2,137.99
|
|
|
Service Code
|
HCPCS Q5157
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$427.60 |
| Max. Negotiated Rate |
$1,924.19 |
| Rate for Payer: Adventist Health Commercial |
$427.60
|
| Rate for Payer: Blue Shield of California Commercial |
$1,714.67
|
| Rate for Payer: Blue Shield of California EPN |
$1,077.55
|
| Rate for Payer: Cash Price |
$962.10
|
| Rate for Payer: Central Health Plan Commercial |
$1,710.39
|
| Rate for Payer: Cigna of CA HMO |
$1,496.59
|
| Rate for Payer: Cigna of CA PPO |
$1,496.59
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,496.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$855.20
|
| Rate for Payer: EPIC Health Plan Senior |
$855.20
|
| Rate for Payer: Galaxy Health WC |
$1,817.29
|
| Rate for Payer: Global Benefits Group Commercial |
$1,282.79
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,924.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,357.62
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,261.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$427.60
|
| Rate for Payer: Multiplan Commercial |
$1,603.49
|
| Rate for Payer: Networks By Design Commercial |
$1,068.99
|
| Rate for Payer: Prime Health Services Commercial |
$1,817.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$802.39
|
| Rate for Payer: United Healthcare All Other HMO |
$781.01
|
| Rate for Payer: United Healthcare HMO Rider |
$764.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$700.19
|
|
|
DENOSUMAB-DSSB 60 MG/ML SUBCUTANEOUS SYRINGE [247538]
|
Facility
|
OP
|
$1,170.00
|
|
|
Service Code
|
HCPCS Q5159
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$32.20 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$710.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$994.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$643.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$877.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$32.20
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40.18
|
| Rate for Payer: Blue Shield of California Commercial |
$741.78
|
| Rate for Payer: Blue Shield of California EPN |
$466.83
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Central Health Plan Commercial |
$936.00
|
| Rate for Payer: Cigna of CA HMO |
$819.00
|
| Rate for Payer: Cigna of CA PPO |
$819.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$994.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$994.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$994.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$819.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$468.00
|
| Rate for Payer: EPIC Health Plan Senior |
$468.00
|
| Rate for Payer: Galaxy Health WC |
$994.50
|
| Rate for Payer: Global Benefits Group Commercial |
$702.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,053.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$742.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$424.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$690.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$819.00
|
| Rate for Payer: Multiplan Commercial |
$877.50
|
| Rate for Payer: Networks By Design Commercial |
$585.00
|
| Rate for Payer: Prime Health Services Commercial |
$994.50
|
| Rate for Payer: Riverside University Health System MISP |
$468.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$702.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$702.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$439.10
|
| Rate for Payer: United Healthcare All Other HMO |
$427.40
|
| Rate for Payer: United Healthcare HMO Rider |
$418.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$383.18
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$994.50
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$994.50
|
| Rate for Payer: Vantage Medical Group Senior |
$994.50
|
|
|
DENOSUMAB-DSSB 60 MG/ML SUBCUTANEOUS SYRINGE [247538]
|
Facility
|
IP
|
$1,170.00
|
|
|
Service Code
|
HCPCS Q5159
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$234.00 |
| Max. Negotiated Rate |
$1,053.00 |
| Rate for Payer: Adventist Health Commercial |
$234.00
|
| Rate for Payer: Blue Shield of California Commercial |
$938.34
|
| Rate for Payer: Blue Shield of California EPN |
$589.68
|
| Rate for Payer: Cash Price |
$526.50
|
| Rate for Payer: Central Health Plan Commercial |
$936.00
|
| Rate for Payer: Cigna of CA HMO |
$819.00
|
| Rate for Payer: Cigna of CA PPO |
$819.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$819.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$468.00
|
| Rate for Payer: EPIC Health Plan Senior |
$468.00
|
| Rate for Payer: Galaxy Health WC |
$994.50
|
| Rate for Payer: Global Benefits Group Commercial |
$702.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1,053.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$742.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$690.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$234.00
|
| Rate for Payer: Multiplan Commercial |
$877.50
|
| Rate for Payer: Networks By Design Commercial |
$585.00
|
| Rate for Payer: Prime Health Services Commercial |
$994.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$439.10
|
| Rate for Payer: United Healthcare All Other HMO |
$427.40
|
| Rate for Payer: United Healthcare HMO Rider |
$418.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$383.18
|
|
|
DENOSUMAB-NXXP 60 MG/ML SUBCUTANEOUS SYRINGE [247605]
|
Facility
|
IP
|
$1,012.80
|
|
|
Service Code
|
HCPCS Q5162
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$202.56 |
| Max. Negotiated Rate |
$911.52 |
| Rate for Payer: Adventist Health Commercial |
$202.56
|
| Rate for Payer: Blue Shield of California Commercial |
$812.27
|
| Rate for Payer: Blue Shield of California EPN |
$510.45
|
| Rate for Payer: Cash Price |
$455.76
|
| Rate for Payer: Central Health Plan Commercial |
$810.24
|
| Rate for Payer: Cigna of CA HMO |
$708.96
|
| Rate for Payer: Cigna of CA PPO |
$708.96
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$708.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$405.12
|
| Rate for Payer: EPIC Health Plan Senior |
$405.12
|
| Rate for Payer: Galaxy Health WC |
$860.88
|
| Rate for Payer: Global Benefits Group Commercial |
$607.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$911.52
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$643.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$597.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.56
|
| Rate for Payer: Multiplan Commercial |
$759.60
|
| Rate for Payer: Networks By Design Commercial |
$506.40
|
| Rate for Payer: Prime Health Services Commercial |
$860.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$380.10
|
| Rate for Payer: United Healthcare All Other HMO |
$369.98
|
| Rate for Payer: United Healthcare HMO Rider |
$361.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$331.69
|
|
|
DENOSUMAB-NXXP 60 MG/ML SUBCUTANEOUS SYRINGE [247605]
|
Facility
|
OP
|
$1,012.80
|
|
|
Service Code
|
HCPCS Q5162
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$15.66 |
| Max. Negotiated Rate |
$911.52 |
| Rate for Payer: Adventist Health Commercial |
$202.56
|
| Rate for Payer: Adventist Health Medi-Cal |
$15.66
|
| Rate for Payer: Aetna of CA HMO/PPO |
$615.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$23.49
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$17.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$15.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$490.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$589.15
|
| Rate for Payer: Blue Shield of California Commercial |
$642.12
|
| Rate for Payer: Blue Shield of California EPN |
$404.11
|
| Rate for Payer: Cash Price |
$455.76
|
| Rate for Payer: Cash Price |
$455.76
|
| Rate for Payer: Central Health Plan Commercial |
$810.24
|
| Rate for Payer: Cigna of CA HMO |
$708.96
|
| Rate for Payer: Cigna of CA PPO |
$708.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.49
|
| Rate for Payer: Dignity Health Medi-Cal |
$17.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.66
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$708.96
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.84
|
| Rate for Payer: EPIC Health Plan Senior |
$17.23
|
| Rate for Payer: Galaxy Health WC |
$860.88
|
| Rate for Payer: Global Benefits Group Commercial |
$607.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$911.52
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$25.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$15.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$15.66
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$643.13
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$35.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$21.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$202.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$20.98
|
| Rate for Payer: Multiplan Commercial |
$759.60
|
| Rate for Payer: Networks By Design Commercial |
$506.40
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$15.66
|
| Rate for Payer: Prime Health Services Commercial |
$860.88
|
| Rate for Payer: Prime Health Services Medicare |
$16.60
|
| Rate for Payer: Riverside University Health System MISP |
$17.23
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$607.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$607.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$380.10
|
| Rate for Payer: United Healthcare All Other HMO |
$369.98
|
| Rate for Payer: United Healthcare HMO Rider |
$361.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$331.69
|
| Rate for Payer: Upland Medical Group Pediatric |
$15.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$23.49
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$17.23
|
| Rate for Payer: Vantage Medical Group Senior |
$15.66
|
|
|
DENOSUMAB-QBDE 60 MG/ML SUBCUTANEOUS SYRINGE [248500]
|
Facility
|
IP
|
$480.00
|
|
|
Service Code
|
HCPCS Q5167
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$96.00 |
| Max. Negotiated Rate |
$432.00 |
| Rate for Payer: Adventist Health Commercial |
$96.00
|
| Rate for Payer: Blue Shield of California Commercial |
$384.96
|
| Rate for Payer: Blue Shield of California EPN |
$241.92
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Central Health Plan Commercial |
$384.00
|
| Rate for Payer: Cigna of CA HMO |
$336.00
|
| Rate for Payer: Cigna of CA PPO |
$336.00
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$192.00
|
| Rate for Payer: EPIC Health Plan Senior |
$192.00
|
| Rate for Payer: Galaxy Health WC |
$408.00
|
| Rate for Payer: Global Benefits Group Commercial |
$288.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$432.00
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$304.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$283.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.00
|
| Rate for Payer: Multiplan Commercial |
$360.00
|
| Rate for Payer: Networks By Design Commercial |
$240.00
|
| Rate for Payer: Prime Health Services Commercial |
$408.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$180.14
|
| Rate for Payer: United Healthcare All Other HMO |
$175.34
|
| Rate for Payer: United Healthcare HMO Rider |
$171.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.20
|
|
|
DENOSUMAB-QBDE 60 MG/ML SUBCUTANEOUS SYRINGE [248500]
|
Facility
|
OP
|
$480.00
|
|
|
Service Code
|
HCPCS Q5167
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.12 |
| Max. Negotiated Rate |
$432.00 |
| Rate for Payer: Adventist Health Commercial |
$96.00
|
| Rate for Payer: Adventist Health Medi-Cal |
$4.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$291.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$232.42
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$279.22
|
| Rate for Payer: Blue Shield of California Commercial |
$304.32
|
| Rate for Payer: Blue Shield of California EPN |
$191.52
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Cash Price |
$216.00
|
| Rate for Payer: Central Health Plan Commercial |
$384.00
|
| Rate for Payer: Cigna of CA HMO |
$336.00
|
| Rate for Payer: Cigna of CA PPO |
$336.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.12
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$336.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.80
|
| Rate for Payer: EPIC Health Plan Senior |
$4.53
|
| Rate for Payer: Galaxy Health WC |
$408.00
|
| Rate for Payer: Global Benefits Group Commercial |
$288.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$432.00
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$304.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$174.24
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5.77
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$96.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5.52
|
| Rate for Payer: Multiplan Commercial |
$360.00
|
| Rate for Payer: Networks By Design Commercial |
$240.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4.12
|
| Rate for Payer: Prime Health Services Commercial |
$408.00
|
| Rate for Payer: Prime Health Services Medicare |
$4.37
|
| Rate for Payer: Riverside University Health System MISP |
$4.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$288.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$288.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$180.14
|
| Rate for Payer: United Healthcare All Other HMO |
$175.34
|
| Rate for Payer: United Healthcare HMO Rider |
$171.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$157.20
|
| Rate for Payer: Upland Medical Group Pediatric |
$4.12
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.53
|
| Rate for Payer: Vantage Medical Group Senior |
$4.12
|
|
|
DENTAL AND ORAL DISEASES WITH CC
|
Facility
|
IP
|
$23,945.03
|
|
|
Service Code
|
MSDRG 158
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$23,945.03 |
| Rate for Payer: Aetna of CA HMO/PPO |
$23,945.03
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,467.51
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21,655.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,191.84
|
| Rate for Payer: EPIC Health Plan Senior |
$14,794.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,449.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$18,829.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,022.46
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,449.60
|
| Rate for Payer: Prime Health Services Medicare |
$14,256.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
DENTAL AND ORAL DISEASES WITH MCC
|
Facility
|
IP
|
$45,184.46
|
|
|
Service Code
|
MSDRG 157
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$45,184.46 |
| Rate for Payer: Aetna of CA HMO/PPO |
$45,184.46
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$29,187.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$40,863.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,556.67
|
| Rate for Payer: EPIC Health Plan Senior |
$27,037.78
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$24,579.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$34,411.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$32,936.93
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$24,579.80
|
| Rate for Payer: Prime Health Services Medicare |
$26,054.59
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
DENTAL AND ORAL DISEASES WITHOUT CC/MCC
|
Facility
|
IP
|
$18,647.01
|
|
|
Service Code
|
MSDRG 159
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$18,647.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$18,647.01
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$12,045.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16,863.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$17,610.88
|
| Rate for Payer: EPIC Health Plan Senior |
$11,740.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$10,673.26
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14,942.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$14,302.17
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$10,673.26
|
| Rate for Payer: Prime Health Services Medicare |
$11,313.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
DENTAL DISEASES AND DISORDERS
|
Facility
|
IP
|
$8,751.65
|
|
|
Service Code
|
APR-DRG 1142
|
| Min. Negotiated Rate |
$5,527.36 |
| Max. Negotiated Rate |
$8,751.65 |
| Rate for Payer: Adventist Health Medi-Cal |
$5,527.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$6,586.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8,751.65
|
|
|
DENTAL DISEASES AND DISORDERS
|
Facility
|
IP
|
$6,250.03
|
|
|
Service Code
|
APR-DRG 1141
|
| Min. Negotiated Rate |
$3,947.39 |
| Max. Negotiated Rate |
$6,250.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,947.39
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,703.97
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$6,250.03
|
|
|
DENTAL DISEASES AND DISORDERS
|
Facility
|
IP
|
$30,049.70
|
|
|
Service Code
|
APR-DRG 1144
|
| Min. Negotiated Rate |
$18,978.76 |
| Max. Negotiated Rate |
$30,049.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$18,978.76
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$22,616.35
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$30,049.70
|
|
|
DENTAL DISEASES AND DISORDERS
|
Facility
|
IP
|
$13,160.71
|
|
|
Service Code
|
APR-DRG 1143
|
| Min. Negotiated Rate |
$8,312.03 |
| Max. Negotiated Rate |
$13,160.71 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,312.03
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,905.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13,160.71
|
|
|
DEPRESSIVE DISORDERS
|
Facility
|
IP
|
$28,301.39
|
|
|
Service Code
|
APR-DRG 7514
|
| Min. Negotiated Rate |
$17,874.56 |
| Max. Negotiated Rate |
$28,301.39 |
| Rate for Payer: Adventist Health Medi-Cal |
$17,874.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$21,300.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$28,301.39
|
|
|
DEPRESSIVE DISORDERS
|
Facility
|
IP
|
$7,347.76
|
|
|
Service Code
|
APR-DRG 7512
|
| Min. Negotiated Rate |
$4,640.69 |
| Max. Negotiated Rate |
$7,347.76 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,640.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5,530.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7,347.76
|
|
|
DEPRESSIVE DISORDERS
|
Facility
|
IP
|
$13,446.74
|
|
|
Service Code
|
APR-DRG 7513
|
| Min. Negotiated Rate |
$8,492.68 |
| Max. Negotiated Rate |
$13,446.74 |
| Rate for Payer: Adventist Health Medi-Cal |
$8,492.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$10,120.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$13,446.74
|
|
|
DEPRESSIVE DISORDERS
|
Facility
|
IP
|
$5,776.70
|
|
|
Service Code
|
APR-DRG 7511
|
| Min. Negotiated Rate |
$3,648.44 |
| Max. Negotiated Rate |
$5,776.70 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,648.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$4,347.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$5,776.70
|
|
|
DEPRESSIVE NEUROSES
|
Facility
|
IP
|
$24,763.55
|
|
|
Service Code
|
MSDRG 881
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$24,763.55 |
| Rate for Payer: Aetna of CA HMO/PPO |
$24,763.55
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$15,996.24
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$22,395.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$22,899.61
|
| Rate for Payer: EPIC Health Plan Senior |
$15,266.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$13,878.55
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$19,429.97
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$18,597.26
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$13,878.55
|
| Rate for Payer: Prime Health Services Medicare |
$14,711.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
