|
ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE [2863]
|
Facility
|
IP
|
$1.68
|
|
|
Service Code
|
NDC 50268-297-15
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.34 |
| Max. Negotiated Rate |
$1.51 |
| Rate for Payer: Adventist Health Commercial |
$0.34
|
| Rate for Payer: Blue Shield of California Commercial |
$1.30
|
| Rate for Payer: Blue Shield of California EPN |
$0.85
|
| Rate for Payer: Cash Price |
$0.92
|
| Rate for Payer: Central Health Plan Commercial |
$1.34
|
| Rate for Payer: Cigna of CA HMO |
$1.18
|
| Rate for Payer: Cigna of CA PPO |
$1.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.67
|
| Rate for Payer: EPIC Health Plan Senior |
$0.67
|
| Rate for Payer: Galaxy Health WC |
$1.43
|
| Rate for Payer: Global Benefits Group Commercial |
$1.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: Multiplan Commercial |
$1.26
|
| Rate for Payer: Networks By Design Commercial |
$1.09
|
| Rate for Payer: Prime Health Services Commercial |
$1.43
|
|
|
ERGOCALCIFEROL (VITAMIN D2) 1,250 MCG (50,000 UNIT) CAPSULE [2863]
|
Facility
|
OP
|
$0.27
|
|
|
Service Code
|
NDC 69452-151-20
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.24 |
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.16
|
| Rate for Payer: Blue Shield of California EPN |
$0.11
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Central Health Plan Commercial |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.19
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Senior |
$0.11
|
| Rate for Payer: Galaxy Health WC |
$0.23
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.24
|
| Rate for Payer: InnovAge PACE Commercial |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.19
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.19
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Networks By Design Commercial |
$0.18
|
| Rate for Payer: Prime Health Services Commercial |
$0.23
|
| Rate for Payer: Riverside University Health System MISP |
$0.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.14
|
| Rate for Payer: United Healthcare All Other HMO |
$0.14
|
| Rate for Payer: United Healthcare HMO Rider |
$0.14
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.14
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.23
|
| Rate for Payer: Vantage Medical Group Senior |
$0.23
|
|
|
ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS [9943]
|
Facility
|
IP
|
$1.66
|
|
|
Service Code
|
NDC 3932835760
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$1.49 |
| Rate for Payer: Adventist Health Commercial |
$0.33
|
| Rate for Payer: Blue Shield of California Commercial |
$1.28
|
| Rate for Payer: Blue Shield of California EPN |
$0.84
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Central Health Plan Commercial |
$1.33
|
| Rate for Payer: Cigna of CA HMO |
$1.16
|
| Rate for Payer: Cigna of CA PPO |
$1.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Senior |
$0.66
|
| Rate for Payer: Galaxy Health WC |
$1.41
|
| Rate for Payer: Global Benefits Group Commercial |
$1.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: Multiplan Commercial |
$1.25
|
| Rate for Payer: Networks By Design Commercial |
$1.08
|
| Rate for Payer: Prime Health Services Commercial |
$1.41
|
|
|
ERGOCALCIFEROL (VITAMIN D2) 200 MCG/ML (8,000 UNIT/ML) ORAL DROPS [9943]
|
Facility
|
OP
|
$1.66
|
|
|
Service Code
|
NDC 3932835760
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$1.49 |
| Rate for Payer: Adventist Health Commercial |
$0.33
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.41
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.91
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.97
|
| Rate for Payer: Blue Shield of California Commercial |
$1.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.66
|
| Rate for Payer: Cash Price |
$0.91
|
| Rate for Payer: Central Health Plan Commercial |
$1.33
|
| Rate for Payer: Cigna of CA HMO |
$1.16
|
| Rate for Payer: Cigna of CA PPO |
$1.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Senior |
$0.66
|
| Rate for Payer: Galaxy Health WC |
$1.41
|
| Rate for Payer: Global Benefits Group Commercial |
$1.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.49
|
| Rate for Payer: InnovAge PACE Commercial |
$0.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.63
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.16
|
| Rate for Payer: Multiplan Commercial |
$1.25
|
| Rate for Payer: Networks By Design Commercial |
$1.08
|
| Rate for Payer: Prime Health Services Commercial |
$1.41
|
| Rate for Payer: Riverside University Health System MISP |
$0.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.83
|
| Rate for Payer: United Healthcare All Other HMO |
$0.83
|
| Rate for Payer: United Healthcare HMO Rider |
$0.83
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.41
|
| Rate for Payer: Vantage Medical Group Senior |
$1.41
|
|
|
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION [106773]
|
Facility
|
IP
|
$846.00
|
|
|
Service Code
|
HCPCS J9179
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$169.20 |
| Max. Negotiated Rate |
$761.40 |
| Rate for Payer: Adventist Health Commercial |
$169.20
|
| Rate for Payer: Blue Shield of California Commercial |
$653.96
|
| Rate for Payer: Blue Shield of California EPN |
$426.38
|
| Rate for Payer: Cash Price |
$465.30
|
| Rate for Payer: Central Health Plan Commercial |
$676.80
|
| Rate for Payer: Cigna of CA HMO |
$592.20
|
| Rate for Payer: Cigna of CA PPO |
$592.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$338.40
|
| Rate for Payer: EPIC Health Plan Senior |
$338.40
|
| Rate for Payer: Galaxy Health WC |
$719.10
|
| Rate for Payer: Global Benefits Group Commercial |
$507.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$761.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$564.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$322.33
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$523.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.20
|
| Rate for Payer: Multiplan Commercial |
$634.50
|
| Rate for Payer: Networks By Design Commercial |
$423.00
|
| Rate for Payer: Prime Health Services Commercial |
$719.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$317.50
|
| Rate for Payer: United Healthcare All Other HMO |
$309.04
|
| Rate for Payer: United Healthcare HMO Rider |
$302.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$277.06
|
|
|
ERIBULIN 1 MG/2 ML (0.5 MG/ML) INTRAVENOUS SOLUTION [106773]
|
Facility
|
OP
|
$846.00
|
|
|
Service Code
|
HCPCS J9179
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$80.31 |
| Max. Negotiated Rate |
$761.40 |
| Rate for Payer: Adventist Health Commercial |
$169.20
|
| Rate for Payer: Adventist Health Medi-Cal |
$104.58
|
| Rate for Payer: Aetna of CA HMO/PPO |
$513.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$156.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$115.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$104.58
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$261.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$80.31
|
| Rate for Payer: Blue Shield of California Commercial |
$169.62
|
| Rate for Payer: Blue Shield of California EPN |
$154.20
|
| Rate for Payer: Cash Price |
$465.30
|
| Rate for Payer: Cash Price |
$465.30
|
| Rate for Payer: Central Health Plan Commercial |
$676.80
|
| Rate for Payer: Cigna of CA HMO |
$592.20
|
| Rate for Payer: Cigna of CA PPO |
$592.20
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$130.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$115.04
|
| Rate for Payer: Dignity Health Medicare Advantage |
$115.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$141.19
|
| Rate for Payer: EPIC Health Plan Senior |
$104.58
|
| Rate for Payer: Galaxy Health WC |
$719.10
|
| Rate for Payer: Global Benefits Group Commercial |
$507.60
|
| Rate for Payer: Health Management Network EPO/PPO |
$761.40
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$171.52
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$118.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$104.58
|
| Rate for Payer: InnovAge PACE Commercial |
$156.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$564.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$253.31
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$104.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$169.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$140.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$140.14
|
| Rate for Payer: Multiplan Commercial |
$634.50
|
| Rate for Payer: Networks By Design Commercial |
$423.00
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$104.58
|
| Rate for Payer: Prime Health Services Commercial |
$719.10
|
| Rate for Payer: Prime Health Services Medicare |
$110.86
|
| Rate for Payer: Riverside University Health System MISP |
$115.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$507.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$507.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$317.50
|
| Rate for Payer: United Healthcare All Other HMO |
$309.04
|
| Rate for Payer: United Healthcare HMO Rider |
$302.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$277.06
|
| Rate for Payer: Upland Medical Group Pediatric |
$104.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$130.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$115.04
|
| Rate for Payer: Vantage Medical Group Senior |
$115.04
|
|
|
ERTAPENEM 1 GRAM INJECTION (IM) [4083192201]
|
Facility
|
IP
|
$166.56
|
|
|
Service Code
|
HCPCS J1335
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$33.31 |
| Max. Negotiated Rate |
$149.90 |
| Rate for Payer: Adventist Health Commercial |
$33.31
|
| Rate for Payer: Adventist Health Commercial |
$30.88
|
| Rate for Payer: Adventist Health Commercial |
$28.10
|
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Adventist Health Commercial |
$7.20
|
| Rate for Payer: Blue Shield of California Commercial |
$108.59
|
| Rate for Payer: Blue Shield of California Commercial |
$27.83
|
| Rate for Payer: Blue Shield of California Commercial |
$128.75
|
| Rate for Payer: Blue Shield of California Commercial |
$92.76
|
| Rate for Payer: Blue Shield of California Commercial |
$119.34
|
| Rate for Payer: Blue Shield of California EPN |
$83.95
|
| Rate for Payer: Blue Shield of California EPN |
$70.80
|
| Rate for Payer: Blue Shield of California EPN |
$18.14
|
| Rate for Payer: Blue Shield of California EPN |
$77.81
|
| Rate for Payer: Blue Shield of California EPN |
$60.48
|
| Rate for Payer: Cash Price |
$84.92
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cash Price |
$91.61
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Central Health Plan Commercial |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$112.38
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Central Health Plan Commercial |
$123.51
|
| Rate for Payer: Central Health Plan Commercial |
$133.25
|
| Rate for Payer: Cigna of CA HMO |
$25.20
|
| Rate for Payer: Cigna of CA HMO |
$108.07
|
| Rate for Payer: Cigna of CA HMO |
$84.00
|
| Rate for Payer: Cigna of CA HMO |
$98.34
|
| Rate for Payer: Cigna of CA HMO |
$116.59
|
| Rate for Payer: Cigna of CA PPO |
$98.34
|
| Rate for Payer: Cigna of CA PPO |
$84.00
|
| Rate for Payer: Cigna of CA PPO |
$25.20
|
| Rate for Payer: Cigna of CA PPO |
$116.59
|
| Rate for Payer: Cigna of CA PPO |
$108.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$56.19
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$66.62
|
| Rate for Payer: EPIC Health Plan Senior |
$14.40
|
| Rate for Payer: EPIC Health Plan Senior |
$61.76
|
| Rate for Payer: Galaxy Health WC |
$131.23
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Galaxy Health WC |
$119.41
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Galaxy Health WC |
$141.58
|
| Rate for Payer: Global Benefits Group Commercial |
$99.94
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Global Benefits Group Commercial |
$92.63
|
| Rate for Payer: Global Benefits Group Commercial |
$84.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$149.90
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$111.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$63.46
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$58.82
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.72
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$95.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$103.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.31
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
| Rate for Payer: Multiplan Commercial |
$115.79
|
| Rate for Payer: Multiplan Commercial |
$105.36
|
| Rate for Payer: Multiplan Commercial |
$124.92
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$83.28
|
| Rate for Payer: Networks By Design Commercial |
$70.24
|
| Rate for Payer: Networks By Design Commercial |
$77.19
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Prime Health Services Commercial |
$119.41
|
| Rate for Payer: Prime Health Services Commercial |
$131.23
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Prime Health Services Commercial |
$141.58
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$45.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.51
|
| Rate for Payer: United Healthcare All Other HMO |
$56.40
|
| Rate for Payer: United Healthcare All Other HMO |
$51.32
|
| Rate for Payer: United Healthcare All Other HMO |
$43.84
|
| Rate for Payer: United Healthcare All Other HMO |
$60.84
|
| Rate for Payer: United Healthcare All Other HMO |
$13.15
|
| Rate for Payer: United Healthcare HMO Rider |
$12.87
|
| Rate for Payer: United Healthcare HMO Rider |
$42.89
|
| Rate for Payer: United Healthcare HMO Rider |
$55.18
|
| Rate for Payer: United Healthcare HMO Rider |
$50.21
|
| Rate for Payer: United Healthcare HMO Rider |
$59.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$54.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.56
|
|
|
ERTAPENEM 1 GRAM INJECTION (IM) [4083192201]
|
Facility
|
OP
|
$140.48
|
|
|
Service Code
|
HCPCS J1335
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$126.43 |
| Rate for Payer: Adventist Health Commercial |
$28.10
|
| Rate for Payer: Adventist Health Commercial |
$30.88
|
| Rate for Payer: Adventist Health Commercial |
$7.20
|
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Adventist Health Commercial |
$33.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$85.31
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$93.76
|
| Rate for Payer: Aetna of CA HMO/PPO |
$101.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$21.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$119.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$30.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$141.58
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$131.23
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$84.91
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$77.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$19.80
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$91.61
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$115.79
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$27.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$105.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$124.92
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.81
|
| Rate for Payer: Blue Shield of California Commercial |
$59.40
|
| Rate for Payer: Blue Shield of California Commercial |
$59.40
|
| Rate for Payer: Blue Shield of California Commercial |
$59.40
|
| Rate for Payer: Blue Shield of California Commercial |
$59.40
|
| Rate for Payer: Blue Shield of California Commercial |
$59.40
|
| Rate for Payer: Blue Shield of California EPN |
$54.00
|
| Rate for Payer: Blue Shield of California EPN |
$54.00
|
| Rate for Payer: Blue Shield of California EPN |
$54.00
|
| Rate for Payer: Blue Shield of California EPN |
$54.00
|
| Rate for Payer: Blue Shield of California EPN |
$54.00
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$19.80
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cash Price |
$84.92
|
| Rate for Payer: Cash Price |
$91.61
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$91.61
|
| Rate for Payer: Cash Price |
$84.92
|
| Rate for Payer: Central Health Plan Commercial |
$112.38
|
| Rate for Payer: Central Health Plan Commercial |
$133.25
|
| Rate for Payer: Central Health Plan Commercial |
$28.80
|
| Rate for Payer: Central Health Plan Commercial |
$123.51
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Cigna of CA HMO |
$25.20
|
| Rate for Payer: Cigna of CA HMO |
$98.34
|
| Rate for Payer: Cigna of CA HMO |
$116.59
|
| Rate for Payer: Cigna of CA HMO |
$108.07
|
| Rate for Payer: Cigna of CA HMO |
$84.00
|
| Rate for Payer: Cigna of CA PPO |
$25.20
|
| Rate for Payer: Cigna of CA PPO |
$116.59
|
| Rate for Payer: Cigna of CA PPO |
$84.00
|
| Rate for Payer: Cigna of CA PPO |
$98.34
|
| Rate for Payer: Cigna of CA PPO |
$108.07
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$131.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$119.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$141.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$30.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$102.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$119.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$131.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$30.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$141.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$119.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$102.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$131.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$141.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$30.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$66.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.40
|
| Rate for Payer: EPIC Health Plan Senior |
$61.76
|
| Rate for Payer: EPIC Health Plan Senior |
$66.62
|
| Rate for Payer: EPIC Health Plan Senior |
$56.19
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$14.40
|
| Rate for Payer: Galaxy Health WC |
$131.23
|
| Rate for Payer: Galaxy Health WC |
$119.41
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Galaxy Health WC |
$141.58
|
| Rate for Payer: Galaxy Health WC |
$30.60
|
| Rate for Payer: Global Benefits Group Commercial |
$84.29
|
| Rate for Payer: Global Benefits Group Commercial |
$21.60
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Global Benefits Group Commercial |
$99.94
|
| Rate for Payer: Global Benefits Group Commercial |
$92.63
|
| Rate for Payer: Health Management Network EPO/PPO |
$32.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$138.95
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$149.90
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.18
|
| Rate for Payer: InnovAge PACE Commercial |
$77.19
|
| Rate for Payer: InnovAge PACE Commercial |
$83.28
|
| Rate for Payer: InnovAge PACE Commercial |
$70.24
|
| Rate for Payer: InnovAge PACE Commercial |
$18.00
|
| Rate for Payer: InnovAge PACE Commercial |
$60.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$24.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$102.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$111.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$22.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$103.10
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$95.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$30.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$33.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$116.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$108.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$98.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$25.20
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$116.59
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$98.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$108.07
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$25.20
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Multiplan Commercial |
$27.00
|
| Rate for Payer: Multiplan Commercial |
$105.36
|
| Rate for Payer: Multiplan Commercial |
$124.92
|
| Rate for Payer: Multiplan Commercial |
$115.79
|
| Rate for Payer: Networks By Design Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$70.24
|
| Rate for Payer: Networks By Design Commercial |
$83.28
|
| Rate for Payer: Networks By Design Commercial |
$18.00
|
| Rate for Payer: Networks By Design Commercial |
$77.19
|
| Rate for Payer: Prime Health Services Commercial |
$30.60
|
| Rate for Payer: Prime Health Services Commercial |
$131.23
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Prime Health Services Commercial |
$119.41
|
| Rate for Payer: Prime Health Services Commercial |
$141.58
|
| Rate for Payer: Riverside University Health System MISP |
$56.19
|
| Rate for Payer: Riverside University Health System MISP |
$48.00
|
| Rate for Payer: Riverside University Health System MISP |
$66.62
|
| Rate for Payer: Riverside University Health System MISP |
$14.40
|
| Rate for Payer: Riverside University Health System MISP |
$61.76
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$92.63
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$84.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$99.94
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$92.63
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$21.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$84.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$99.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$45.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$62.51
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$13.51
|
| Rate for Payer: United Healthcare All Other HMO |
$60.84
|
| Rate for Payer: United Healthcare All Other HMO |
$51.32
|
| Rate for Payer: United Healthcare All Other HMO |
$13.15
|
| Rate for Payer: United Healthcare All Other HMO |
$43.84
|
| Rate for Payer: United Healthcare All Other HMO |
$56.40
|
| Rate for Payer: United Healthcare HMO Rider |
$55.18
|
| Rate for Payer: United Healthcare HMO Rider |
$59.53
|
| Rate for Payer: United Healthcare HMO Rider |
$50.21
|
| Rate for Payer: United Healthcare HMO Rider |
$42.89
|
| Rate for Payer: United Healthcare HMO Rider |
$12.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11.79
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$50.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$54.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$131.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$30.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$119.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$102.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$141.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$30.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$131.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$119.41
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$141.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.00
|
| Rate for Payer: Vantage Medical Group Senior |
$131.23
|
| Rate for Payer: Vantage Medical Group Senior |
$102.00
|
| Rate for Payer: Vantage Medical Group Senior |
$141.58
|
| Rate for Payer: Vantage Medical Group Senior |
$30.60
|
| Rate for Payer: Vantage Medical Group Senior |
$119.41
|
|
|
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION [31922]
|
Facility
|
OP
|
$140.48
|
|
|
Service Code
|
HCPCS J1335
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.18 |
| Max. Negotiated Rate |
$126.43 |
| Rate for Payer: Adventist Health Commercial |
$28.10
|
| Rate for Payer: Adventist Health Commercial |
$9.60
|
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Aetna of CA HMO/PPO |
$29.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$72.88
|
| Rate for Payer: Aetna of CA HMO/PPO |
$85.31
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$119.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$40.80
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$102.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$77.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$66.00
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$26.40
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$90.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$105.36
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$36.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$97.12
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$29.81
|
| Rate for Payer: Blue Shield of California Commercial |
$59.40
|
| Rate for Payer: Blue Shield of California Commercial |
$59.40
|
| Rate for Payer: Blue Shield of California Commercial |
$59.40
|
| Rate for Payer: Blue Shield of California EPN |
$54.00
|
| Rate for Payer: Blue Shield of California EPN |
$54.00
|
| Rate for Payer: Blue Shield of California EPN |
$54.00
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Central Health Plan Commercial |
$38.40
|
| Rate for Payer: Central Health Plan Commercial |
$112.38
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Cigna of CA HMO |
$33.60
|
| Rate for Payer: Cigna of CA HMO |
$98.34
|
| Rate for Payer: Cigna of CA HMO |
$84.00
|
| Rate for Payer: Cigna of CA PPO |
$84.00
|
| Rate for Payer: Cigna of CA PPO |
$33.60
|
| Rate for Payer: Cigna of CA PPO |
$98.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$40.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$102.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$119.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$102.00
|
| Rate for Payer: Dignity Health Medi-Cal |
$119.41
|
| Rate for Payer: Dignity Health Medi-Cal |
$40.80
|
| Rate for Payer: Dignity Health Medicare Advantage |
$119.41
|
| Rate for Payer: Dignity Health Medicare Advantage |
$102.00
|
| Rate for Payer: Dignity Health Medicare Advantage |
$40.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.20
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$56.19
|
| Rate for Payer: EPIC Health Plan Senior |
$19.20
|
| Rate for Payer: Galaxy Health WC |
$40.80
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Galaxy Health WC |
$119.41
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Global Benefits Group Commercial |
$28.80
|
| Rate for Payer: Global Benefits Group Commercial |
$84.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.18
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9.18
|
| Rate for Payer: InnovAge PACE Commercial |
$24.00
|
| Rate for Payer: InnovAge PACE Commercial |
$70.24
|
| Rate for Payer: InnovAge PACE Commercial |
$60.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.39
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$29.39
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$33.60
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$98.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$84.00
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$98.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33.60
|
| Rate for Payer: Multiplan Commercial |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Multiplan Commercial |
$105.36
|
| Rate for Payer: Networks By Design Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$24.00
|
| Rate for Payer: Networks By Design Commercial |
$70.24
|
| Rate for Payer: Prime Health Services Commercial |
$119.41
|
| Rate for Payer: Prime Health Services Commercial |
$40.80
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: Riverside University Health System MISP |
$19.20
|
| Rate for Payer: Riverside University Health System MISP |
$56.19
|
| Rate for Payer: Riverside University Health System MISP |
$48.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$84.29
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$28.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$72.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$84.29
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$28.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$72.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.72
|
| Rate for Payer: United Healthcare All Other Commercial |
$45.04
|
| Rate for Payer: United Healthcare All Other HMO |
$43.84
|
| Rate for Payer: United Healthcare All Other HMO |
$51.32
|
| Rate for Payer: United Healthcare All Other HMO |
$17.53
|
| Rate for Payer: United Healthcare HMO Rider |
$50.21
|
| Rate for Payer: United Healthcare HMO Rider |
$42.89
|
| Rate for Payer: United Healthcare HMO Rider |
$17.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$119.41
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$102.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$40.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$102.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$40.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$119.41
|
| Rate for Payer: Vantage Medical Group Senior |
$119.41
|
| Rate for Payer: Vantage Medical Group Senior |
$102.00
|
| Rate for Payer: Vantage Medical Group Senior |
$40.80
|
|
|
ERTAPENEM 1 GRAM SOLUTION FOR INJECTION [31922]
|
Facility
|
IP
|
$48.00
|
|
|
Service Code
|
HCPCS J1335
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.60 |
| Max. Negotiated Rate |
$43.20 |
| Rate for Payer: Adventist Health Commercial |
$9.60
|
| Rate for Payer: Adventist Health Commercial |
$28.10
|
| Rate for Payer: Adventist Health Commercial |
$24.00
|
| Rate for Payer: Blue Shield of California Commercial |
$37.10
|
| Rate for Payer: Blue Shield of California Commercial |
$108.59
|
| Rate for Payer: Blue Shield of California Commercial |
$92.76
|
| Rate for Payer: Blue Shield of California EPN |
$60.48
|
| Rate for Payer: Blue Shield of California EPN |
$24.19
|
| Rate for Payer: Blue Shield of California EPN |
$70.80
|
| Rate for Payer: Cash Price |
$26.40
|
| Rate for Payer: Cash Price |
$66.00
|
| Rate for Payer: Cash Price |
$77.27
|
| Rate for Payer: Central Health Plan Commercial |
$112.38
|
| Rate for Payer: Central Health Plan Commercial |
$96.00
|
| Rate for Payer: Central Health Plan Commercial |
$38.40
|
| Rate for Payer: Cigna of CA HMO |
$33.60
|
| Rate for Payer: Cigna of CA HMO |
$84.00
|
| Rate for Payer: Cigna of CA HMO |
$98.34
|
| Rate for Payer: Cigna of CA PPO |
$33.60
|
| Rate for Payer: Cigna of CA PPO |
$98.34
|
| Rate for Payer: Cigna of CA PPO |
$84.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$56.19
|
| Rate for Payer: EPIC Health Plan Commercial |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$56.19
|
| Rate for Payer: EPIC Health Plan Senior |
$48.00
|
| Rate for Payer: EPIC Health Plan Senior |
$19.20
|
| Rate for Payer: Galaxy Health WC |
$119.41
|
| Rate for Payer: Galaxy Health WC |
$102.00
|
| Rate for Payer: Galaxy Health WC |
$40.80
|
| Rate for Payer: Global Benefits Group Commercial |
$84.29
|
| Rate for Payer: Global Benefits Group Commercial |
$72.00
|
| Rate for Payer: Global Benefits Group Commercial |
$28.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$43.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$126.43
|
| Rate for Payer: Health Management Network EPO/PPO |
$108.00
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$32.02
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$80.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$93.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$45.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$18.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$53.52
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29.71
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$86.96
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$74.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.00
|
| Rate for Payer: Multiplan Commercial |
$36.00
|
| Rate for Payer: Multiplan Commercial |
$105.36
|
| Rate for Payer: Multiplan Commercial |
$90.00
|
| Rate for Payer: Networks By Design Commercial |
$24.00
|
| Rate for Payer: Networks By Design Commercial |
$60.00
|
| Rate for Payer: Networks By Design Commercial |
$70.24
|
| Rate for Payer: Prime Health Services Commercial |
$119.41
|
| Rate for Payer: Prime Health Services Commercial |
$40.80
|
| Rate for Payer: Prime Health Services Commercial |
$102.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$45.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$18.01
|
| Rate for Payer: United Healthcare All Other Commercial |
$52.72
|
| Rate for Payer: United Healthcare All Other HMO |
$51.32
|
| Rate for Payer: United Healthcare All Other HMO |
$43.84
|
| Rate for Payer: United Healthcare All Other HMO |
$17.53
|
| Rate for Payer: United Healthcare HMO Rider |
$42.89
|
| Rate for Payer: United Healthcare HMO Rider |
$50.21
|
| Rate for Payer: United Healthcare HMO Rider |
$17.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$46.01
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$15.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$39.30
|
|
|
ERYTHROMYCIN 250 MG TABLET [2889]
|
Facility
|
OP
|
$6.75
|
|
|
Service Code
|
NDC 75834-242-30
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$6.08 |
| Rate for Payer: Adventist Health Commercial |
$1.35
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$5.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.71
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.96
|
| Rate for Payer: Blue Shield of California Commercial |
$4.12
|
| Rate for Payer: Blue Shield of California EPN |
$2.69
|
| Rate for Payer: Cash Price |
$3.71
|
| Rate for Payer: Central Health Plan Commercial |
$5.40
|
| Rate for Payer: Cigna of CA HMO |
$4.72
|
| Rate for Payer: Cigna of CA PPO |
$4.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$5.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$5.74
|
| Rate for Payer: Dignity Health Medicare Advantage |
$5.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.70
|
| Rate for Payer: EPIC Health Plan Senior |
$2.70
|
| Rate for Payer: Galaxy Health WC |
$5.74
|
| Rate for Payer: Global Benefits Group Commercial |
$4.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.08
|
| Rate for Payer: InnovAge PACE Commercial |
$3.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.72
|
| Rate for Payer: Multiplan Commercial |
$5.06
|
| Rate for Payer: Networks By Design Commercial |
$4.39
|
| Rate for Payer: Prime Health Services Commercial |
$5.74
|
| Rate for Payer: Riverside University Health System MISP |
$2.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.38
|
| Rate for Payer: United Healthcare All Other HMO |
$3.38
|
| Rate for Payer: United Healthcare HMO Rider |
$3.38
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.38
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$5.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: Vantage Medical Group Senior |
$5.74
|
|
|
ERYTHROMYCIN 250 MG TABLET [2889]
|
Facility
|
IP
|
$6.75
|
|
|
Service Code
|
NDC 75834-242-30
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.35 |
| Max. Negotiated Rate |
$6.08 |
| Rate for Payer: Adventist Health Commercial |
$1.35
|
| Rate for Payer: Blue Shield of California Commercial |
$5.22
|
| Rate for Payer: Blue Shield of California EPN |
$3.40
|
| Rate for Payer: Cash Price |
$3.71
|
| Rate for Payer: Central Health Plan Commercial |
$5.40
|
| Rate for Payer: Cigna of CA HMO |
$4.72
|
| Rate for Payer: Cigna of CA PPO |
$4.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.70
|
| Rate for Payer: EPIC Health Plan Senior |
$2.70
|
| Rate for Payer: Galaxy Health WC |
$5.74
|
| Rate for Payer: Global Benefits Group Commercial |
$4.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$6.08
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.50
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.57
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.35
|
| Rate for Payer: Multiplan Commercial |
$5.06
|
| Rate for Payer: Networks By Design Commercial |
$4.39
|
| Rate for Payer: Prime Health Services Commercial |
$5.74
|
|
|
ERYTHROMYCIN 250 MG TABLET [2889]
|
Facility
|
OP
|
$5.74
|
|
|
Service Code
|
NDC 70710-1047-3
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$5.17 |
| Rate for Payer: Adventist Health Commercial |
$1.15
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.16
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.30
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.37
|
| Rate for Payer: Blue Shield of California Commercial |
$3.51
|
| Rate for Payer: Blue Shield of California EPN |
$2.29
|
| Rate for Payer: Cash Price |
$3.16
|
| Rate for Payer: Central Health Plan Commercial |
$4.59
|
| Rate for Payer: Cigna of CA HMO |
$4.02
|
| Rate for Payer: Cigna of CA PPO |
$4.02
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.88
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.30
|
| Rate for Payer: EPIC Health Plan Senior |
$2.30
|
| Rate for Payer: Galaxy Health WC |
$4.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.17
|
| Rate for Payer: InnovAge PACE Commercial |
$2.87
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.02
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.02
|
| Rate for Payer: Multiplan Commercial |
$4.30
|
| Rate for Payer: Networks By Design Commercial |
$3.73
|
| Rate for Payer: Prime Health Services Commercial |
$4.88
|
| Rate for Payer: Riverside University Health System MISP |
$2.30
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.87
|
| Rate for Payer: United Healthcare All Other HMO |
$2.87
|
| Rate for Payer: United Healthcare HMO Rider |
$2.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.88
|
| Rate for Payer: Vantage Medical Group Senior |
$4.88
|
|
|
ERYTHROMYCIN 250 MG TABLET [2889]
|
Facility
|
IP
|
$5.74
|
|
|
Service Code
|
NDC 70710-1047-3
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.15 |
| Max. Negotiated Rate |
$5.17 |
| Rate for Payer: Adventist Health Commercial |
$1.15
|
| Rate for Payer: Blue Shield of California Commercial |
$4.44
|
| Rate for Payer: Blue Shield of California EPN |
$2.89
|
| Rate for Payer: Cash Price |
$3.16
|
| Rate for Payer: Central Health Plan Commercial |
$4.59
|
| Rate for Payer: Cigna of CA HMO |
$4.02
|
| Rate for Payer: Cigna of CA PPO |
$4.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.30
|
| Rate for Payer: EPIC Health Plan Senior |
$2.30
|
| Rate for Payer: Galaxy Health WC |
$4.88
|
| Rate for Payer: Global Benefits Group Commercial |
$3.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.19
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.55
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.15
|
| Rate for Payer: Multiplan Commercial |
$4.30
|
| Rate for Payer: Networks By Design Commercial |
$3.73
|
| Rate for Payer: Prime Health Services Commercial |
$4.88
|
|
|
ERYTHROMYCIN 250 MG TABLET [2889]
|
Facility
|
OP
|
$7.94
|
|
|
Service Code
|
NDC 0093-5571-56
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Adventist Health Commercial |
$1.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.66
|
| Rate for Payer: Blue Shield of California Commercial |
$4.85
|
| Rate for Payer: Blue Shield of California EPN |
$3.17
|
| Rate for Payer: Cash Price |
$4.37
|
| Rate for Payer: Central Health Plan Commercial |
$6.35
|
| Rate for Payer: Cigna of CA HMO |
$5.56
|
| Rate for Payer: Cigna of CA PPO |
$5.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.18
|
| Rate for Payer: EPIC Health Plan Senior |
$3.18
|
| Rate for Payer: Galaxy Health WC |
$6.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.15
|
| Rate for Payer: InnovAge PACE Commercial |
$3.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.56
|
| Rate for Payer: Multiplan Commercial |
$5.96
|
| Rate for Payer: Networks By Design Commercial |
$5.16
|
| Rate for Payer: Prime Health Services Commercial |
$6.75
|
| Rate for Payer: Riverside University Health System MISP |
$3.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.97
|
| Rate for Payer: United Healthcare All Other HMO |
$3.97
|
| Rate for Payer: United Healthcare HMO Rider |
$3.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.75
|
| Rate for Payer: Vantage Medical Group Senior |
$6.75
|
|
|
ERYTHROMYCIN 250 MG TABLET [2889]
|
Facility
|
IP
|
$7.94
|
|
|
Service Code
|
NDC 0093-5571-56
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Adventist Health Commercial |
$1.59
|
| Rate for Payer: Blue Shield of California Commercial |
$6.14
|
| Rate for Payer: Blue Shield of California EPN |
$4.00
|
| Rate for Payer: Cash Price |
$4.37
|
| Rate for Payer: Central Health Plan Commercial |
$6.35
|
| Rate for Payer: Cigna of CA HMO |
$5.56
|
| Rate for Payer: Cigna of CA PPO |
$5.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.18
|
| Rate for Payer: EPIC Health Plan Senior |
$3.18
|
| Rate for Payer: Galaxy Health WC |
$6.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.59
|
| Rate for Payer: Multiplan Commercial |
$5.96
|
| Rate for Payer: Networks By Design Commercial |
$5.16
|
| Rate for Payer: Prime Health Services Commercial |
$6.75
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINT 3.5G BULK [4082888]
|
Facility
|
OP
|
$5.21
|
|
|
Service Code
|
NDC 24208-910-55
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.04 |
| Max. Negotiated Rate |
$4.69 |
| Rate for Payer: Adventist Health Commercial |
$1.04
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.87
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.06
|
| Rate for Payer: Blue Shield of California Commercial |
$3.18
|
| Rate for Payer: Blue Shield of California EPN |
$2.08
|
| Rate for Payer: Cash Price |
$2.87
|
| Rate for Payer: Central Health Plan Commercial |
$4.17
|
| Rate for Payer: Cigna of CA HMO |
$3.65
|
| Rate for Payer: Cigna of CA PPO |
$3.65
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.43
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.08
|
| Rate for Payer: EPIC Health Plan Senior |
$2.08
|
| Rate for Payer: Galaxy Health WC |
$4.43
|
| Rate for Payer: Global Benefits Group Commercial |
$3.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.69
|
| Rate for Payer: InnovAge PACE Commercial |
$2.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.65
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.65
|
| Rate for Payer: Multiplan Commercial |
$3.91
|
| Rate for Payer: Networks By Design Commercial |
$3.39
|
| Rate for Payer: Prime Health Services Commercial |
$4.43
|
| Rate for Payer: Riverside University Health System MISP |
$2.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.60
|
| Rate for Payer: United Healthcare All Other HMO |
$2.60
|
| Rate for Payer: United Healthcare HMO Rider |
$2.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.60
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.43
|
| Rate for Payer: Vantage Medical Group Senior |
$4.43
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINT 3.5G BULK [4082888]
|
Facility
|
IP
|
$5.21
|
|
|
Service Code
|
NDC 24208-910-55
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.04 |
| Max. Negotiated Rate |
$4.69 |
| Rate for Payer: Adventist Health Commercial |
$1.04
|
| Rate for Payer: Blue Shield of California Commercial |
$4.03
|
| Rate for Payer: Blue Shield of California EPN |
$2.63
|
| Rate for Payer: Cash Price |
$2.87
|
| Rate for Payer: Central Health Plan Commercial |
$4.17
|
| Rate for Payer: Cigna of CA HMO |
$3.65
|
| Rate for Payer: Cigna of CA PPO |
$3.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.08
|
| Rate for Payer: EPIC Health Plan Senior |
$2.08
|
| Rate for Payer: Galaxy Health WC |
$4.43
|
| Rate for Payer: Global Benefits Group Commercial |
$3.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.99
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$3.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.04
|
| Rate for Payer: Multiplan Commercial |
$3.91
|
| Rate for Payer: Networks By Design Commercial |
$3.39
|
| Rate for Payer: Prime Health Services Commercial |
$4.43
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [2888]
|
Facility
|
OP
|
$9.51
|
|
|
Service Code
|
NDC 72485-670-31
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$8.56 |
| Rate for Payer: Adventist Health Commercial |
$1.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$5.78
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$8.08
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$5.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$4.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$5.59
|
| Rate for Payer: Blue Shield of California Commercial |
$5.81
|
| Rate for Payer: Blue Shield of California EPN |
$3.79
|
| Rate for Payer: Cash Price |
$5.23
|
| Rate for Payer: Central Health Plan Commercial |
$7.61
|
| Rate for Payer: Cigna of CA HMO |
$6.66
|
| Rate for Payer: Cigna of CA PPO |
$6.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$8.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3.80
|
| Rate for Payer: Galaxy Health WC |
$8.08
|
| Rate for Payer: Global Benefits Group Commercial |
$5.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.56
|
| Rate for Payer: InnovAge PACE Commercial |
$4.75
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$6.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$6.66
|
| Rate for Payer: Multiplan Commercial |
$7.13
|
| Rate for Payer: Networks By Design Commercial |
$6.18
|
| Rate for Payer: Prime Health Services Commercial |
$8.08
|
| Rate for Payer: Riverside University Health System MISP |
$3.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$5.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$5.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.75
|
| Rate for Payer: United Healthcare All Other HMO |
$4.75
|
| Rate for Payer: United Healthcare HMO Rider |
$4.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$8.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.08
|
| Rate for Payer: Vantage Medical Group Senior |
$8.08
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [2888]
|
Facility
|
OP
|
$11.92
|
|
|
Service Code
|
NDC 24208-910-19
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$10.73 |
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.94
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5.77
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$7.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7.28
|
| Rate for Payer: Blue Shield of California EPN |
$4.76
|
| Rate for Payer: Cash Price |
$6.55
|
| Rate for Payer: Central Health Plan Commercial |
$9.54
|
| Rate for Payer: Cigna of CA HMO |
$8.34
|
| Rate for Payer: Cigna of CA PPO |
$8.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$10.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.77
|
| Rate for Payer: EPIC Health Plan Senior |
$4.77
|
| Rate for Payer: Galaxy Health WC |
$10.13
|
| Rate for Payer: Global Benefits Group Commercial |
$7.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.73
|
| Rate for Payer: InnovAge PACE Commercial |
$5.96
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$8.34
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$8.34
|
| Rate for Payer: Multiplan Commercial |
$8.94
|
| Rate for Payer: Networks By Design Commercial |
$7.75
|
| Rate for Payer: Prime Health Services Commercial |
$10.13
|
| Rate for Payer: Riverside University Health System MISP |
$4.77
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.15
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.96
|
| Rate for Payer: United Healthcare All Other HMO |
$5.96
|
| Rate for Payer: United Healthcare HMO Rider |
$5.96
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.96
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$10.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.13
|
| Rate for Payer: Vantage Medical Group Senior |
$10.13
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [2888]
|
Facility
|
IP
|
$11.92
|
|
|
Service Code
|
NDC 24208-910-19
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$2.38 |
| Max. Negotiated Rate |
$10.73 |
| Rate for Payer: Adventist Health Commercial |
$2.38
|
| Rate for Payer: Blue Shield of California Commercial |
$9.21
|
| Rate for Payer: Blue Shield of California EPN |
$6.01
|
| Rate for Payer: Cash Price |
$6.55
|
| Rate for Payer: Central Health Plan Commercial |
$9.54
|
| Rate for Payer: Cigna of CA HMO |
$8.34
|
| Rate for Payer: Cigna of CA PPO |
$8.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.77
|
| Rate for Payer: EPIC Health Plan Senior |
$4.77
|
| Rate for Payer: Galaxy Health WC |
$10.13
|
| Rate for Payer: Global Benefits Group Commercial |
$7.15
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.73
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$7.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.38
|
| Rate for Payer: Multiplan Commercial |
$8.94
|
| Rate for Payer: Networks By Design Commercial |
$7.75
|
| Rate for Payer: Prime Health Services Commercial |
$10.13
|
|
|
ERYTHROMYCIN 5 MG/GRAM (0.5 %) EYE OINTMENT [2888]
|
Facility
|
IP
|
$9.51
|
|
|
Service Code
|
NDC 72485-670-31
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.90 |
| Max. Negotiated Rate |
$8.56 |
| Rate for Payer: Adventist Health Commercial |
$1.90
|
| Rate for Payer: Blue Shield of California Commercial |
$7.35
|
| Rate for Payer: Blue Shield of California EPN |
$4.79
|
| Rate for Payer: Cash Price |
$5.23
|
| Rate for Payer: Central Health Plan Commercial |
$7.61
|
| Rate for Payer: Cigna of CA HMO |
$6.66
|
| Rate for Payer: Cigna of CA PPO |
$6.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.80
|
| Rate for Payer: EPIC Health Plan Senior |
$3.80
|
| Rate for Payer: Galaxy Health WC |
$8.08
|
| Rate for Payer: Global Benefits Group Commercial |
$5.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$8.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$6.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.62
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$5.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.90
|
| Rate for Payer: Multiplan Commercial |
$7.13
|
| Rate for Payer: Networks By Design Commercial |
$6.18
|
| Rate for Payer: Prime Health Services Commercial |
$8.08
|
|
|
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION [2899]
|
Facility
|
IP
|
$2.49
|
|
|
Service Code
|
NDC 52536-134-13
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$2.24 |
| Rate for Payer: Adventist Health Commercial |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$1.92
|
| Rate for Payer: Blue Shield of California EPN |
$1.25
|
| Rate for Payer: Cash Price |
$1.37
|
| Rate for Payer: Central Health Plan Commercial |
$1.99
|
| Rate for Payer: Cigna of CA HMO |
$1.74
|
| Rate for Payer: Cigna of CA PPO |
$1.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1.00
|
| Rate for Payer: Galaxy Health WC |
$2.12
|
| Rate for Payer: Global Benefits Group Commercial |
$1.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.50
|
| Rate for Payer: Multiplan Commercial |
$1.87
|
| Rate for Payer: Networks By Design Commercial |
$1.62
|
| Rate for Payer: Prime Health Services Commercial |
$2.12
|
|
|
ERYTHROMYCIN ETHYLSUCCINATE 200 MG/5 ML ORAL POWDER FOR SUSPENSION [2899]
|
Facility
|
OP
|
$2.49
|
|
|
Service Code
|
NDC 52536-134-13
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.50 |
| Max. Negotiated Rate |
$2.24 |
| Rate for Payer: Adventist Health Commercial |
$0.50
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.51
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.87
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.21
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.46
|
| Rate for Payer: Blue Shield of California Commercial |
$1.52
|
| Rate for Payer: Blue Shield of California EPN |
$0.99
|
| Rate for Payer: Cash Price |
$1.37
|
| Rate for Payer: Central Health Plan Commercial |
$1.99
|
| Rate for Payer: Cigna of CA HMO |
$1.74
|
| Rate for Payer: Cigna of CA PPO |
$1.74
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.12
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.00
|
| Rate for Payer: EPIC Health Plan Senior |
$1.00
|
| Rate for Payer: Galaxy Health WC |
$2.12
|
| Rate for Payer: Global Benefits Group Commercial |
$1.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.24
|
| Rate for Payer: InnovAge PACE Commercial |
$1.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.66
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.95
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$1.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.74
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.74
|
| Rate for Payer: Multiplan Commercial |
$1.87
|
| Rate for Payer: Networks By Design Commercial |
$1.62
|
| Rate for Payer: Prime Health Services Commercial |
$2.12
|
| Rate for Payer: Riverside University Health System MISP |
$1.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.25
|
| Rate for Payer: United Healthcare All Other HMO |
$1.25
|
| Rate for Payer: United Healthcare HMO Rider |
$1.25
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.12
|
| Rate for Payer: Vantage Medical Group Senior |
$2.12
|
|
|
ERYTHROMYCIN ETHYLSUCCINATE 400 MG/5 ML ORAL POWDER FOR SUSPENSION [2900]
|
Facility
|
OP
|
$7.94
|
|
|
Service Code
|
NDC 24338-130-13
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.59 |
| Max. Negotiated Rate |
$7.15 |
| Rate for Payer: Adventist Health Commercial |
$1.59
|
| Rate for Payer: Aetna of CA HMO/PPO |
$4.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4.37
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$5.96
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.84
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.66
|
| Rate for Payer: Blue Shield of California Commercial |
$4.85
|
| Rate for Payer: Blue Shield of California EPN |
$3.17
|
| Rate for Payer: Cash Price |
$4.37
|
| Rate for Payer: Central Health Plan Commercial |
$6.35
|
| Rate for Payer: Cigna of CA HMO |
$5.56
|
| Rate for Payer: Cigna of CA PPO |
$5.56
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.75
|
| Rate for Payer: Dignity Health Medicare Advantage |
$6.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.18
|
| Rate for Payer: EPIC Health Plan Senior |
$3.18
|
| Rate for Payer: Galaxy Health WC |
$6.75
|
| Rate for Payer: Global Benefits Group Commercial |
$4.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$7.15
|
| Rate for Payer: InnovAge PACE Commercial |
$3.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$5.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.03
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$4.91
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.59
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$5.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$5.56
|
| Rate for Payer: Multiplan Commercial |
$5.96
|
| Rate for Payer: Networks By Design Commercial |
$5.16
|
| Rate for Payer: Prime Health Services Commercial |
$6.75
|
| Rate for Payer: Riverside University Health System MISP |
$3.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$4.76
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$4.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.97
|
| Rate for Payer: United Healthcare All Other HMO |
$3.97
|
| Rate for Payer: United Healthcare HMO Rider |
$3.97
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6.75
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.75
|
| Rate for Payer: Vantage Medical Group Senior |
$6.75
|
|
