|
GALANTAMINE ER 16 MG 24 HR CAPSULE,EXTENDED RELEASE [41139]
|
Facility
|
OP
|
$5.50
|
|
|
Service Code
|
NDC 0378810693
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.10 |
| Max. Negotiated Rate |
$4.95 |
| Rate for Payer: Adventist Health Commercial |
$1.10
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.66
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.20
|
| Rate for Payer: Blue Shield of California Commercial |
$3.49
|
| Rate for Payer: Blue Shield of California EPN |
$2.19
|
| Rate for Payer: Cash Price |
$2.48
|
| Rate for Payer: Central Health Plan Commercial |
$4.40
|
| Rate for Payer: Cigna of CA HMO |
$3.85
|
| Rate for Payer: Cigna of CA PPO |
$3.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.67
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.67
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4.67
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$3.85
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.20
|
| Rate for Payer: EPIC Health Plan Senior |
$2.20
|
| Rate for Payer: Galaxy Health WC |
$4.67
|
| Rate for Payer: Global Benefits Group Commercial |
$3.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$3.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$3.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$3.85
|
| Rate for Payer: Multiplan Commercial |
$4.12
|
| Rate for Payer: Networks By Design Commercial |
$3.58
|
| Rate for Payer: Prime Health Services Commercial |
$4.67
|
| Rate for Payer: Riverside University Health System MISP |
$2.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.30
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.75
|
| Rate for Payer: United Healthcare All Other HMO |
$2.75
|
| Rate for Payer: United Healthcare HMO Rider |
$2.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.75
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.67
|
| Rate for Payer: Vantage Medical Group Senior |
$4.67
|
|
|
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION [41550]
|
Facility
|
OP
|
$611.76
|
|
|
Service Code
|
HCPCS J1458
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$122.35 |
| Max. Negotiated Rate |
$3,004.84 |
| Rate for Payer: Adventist Health Commercial |
$122.35
|
| Rate for Payer: Adventist Health Medi-Cal |
$525.97
|
| Rate for Payer: Aetna of CA HMO/PPO |
$3,004.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$788.96
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$578.57
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$525.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$597.76
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$745.95
|
| Rate for Payer: Blue Shield of California Commercial |
$619.34
|
| Rate for Payer: Blue Shield of California EPN |
$563.04
|
| Rate for Payer: Cash Price |
$275.29
|
| Rate for Payer: Cash Price |
$275.29
|
| Rate for Payer: Central Health Plan Commercial |
$489.41
|
| Rate for Payer: Cigna of CA HMO |
$428.23
|
| Rate for Payer: Cigna of CA PPO |
$428.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$788.96
|
| Rate for Payer: Dignity Health Medi-Cal |
$578.57
|
| Rate for Payer: Dignity Health Medicare Advantage |
$525.97
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$428.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$867.85
|
| Rate for Payer: EPIC Health Plan Senior |
$578.57
|
| Rate for Payer: Galaxy Health WC |
$520.00
|
| Rate for Payer: Global Benefits Group Commercial |
$367.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$550.58
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$862.59
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$525.97
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$525.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$388.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$976.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$736.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$704.80
|
| Rate for Payer: Multiplan Commercial |
$458.82
|
| Rate for Payer: Networks By Design Commercial |
$305.88
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$525.97
|
| Rate for Payer: Prime Health Services Commercial |
$520.00
|
| Rate for Payer: Prime Health Services Medicare |
$557.53
|
| Rate for Payer: Riverside University Health System MISP |
$578.57
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$367.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$367.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$229.59
|
| Rate for Payer: United Healthcare All Other HMO |
$223.48
|
| Rate for Payer: United Healthcare HMO Rider |
$218.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.35
|
| Rate for Payer: Upland Medical Group Pediatric |
$525.97
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$788.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$578.57
|
| Rate for Payer: Vantage Medical Group Senior |
$525.97
|
|
|
GALSULFASE 5 MG/5 ML INTRAVENOUS SOLUTION [41550]
|
Facility
|
IP
|
$611.76
|
|
|
Service Code
|
HCPCS J1458
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$122.35 |
| Max. Negotiated Rate |
$550.58 |
| Rate for Payer: Adventist Health Commercial |
$122.35
|
| Rate for Payer: Blue Shield of California Commercial |
$490.63
|
| Rate for Payer: Blue Shield of California EPN |
$308.33
|
| Rate for Payer: Cash Price |
$275.29
|
| Rate for Payer: Central Health Plan Commercial |
$489.41
|
| Rate for Payer: Cigna of CA HMO |
$428.23
|
| Rate for Payer: Cigna of CA PPO |
$428.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$428.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$244.70
|
| Rate for Payer: EPIC Health Plan Senior |
$244.70
|
| Rate for Payer: Galaxy Health WC |
$520.00
|
| Rate for Payer: Global Benefits Group Commercial |
$367.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$550.58
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$388.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$360.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$122.35
|
| Rate for Payer: Multiplan Commercial |
$458.82
|
| Rate for Payer: Networks By Design Commercial |
$305.88
|
| Rate for Payer: Prime Health Services Commercial |
$520.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$229.59
|
| Rate for Payer: United Healthcare All Other HMO |
$223.48
|
| Rate for Payer: United Healthcare HMO Rider |
$218.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$200.35
|
|
|
GANCICLOVIR 0.15 % EYE GEL [104575]
|
Facility
|
IP
|
$114.51
|
|
|
Service Code
|
NDC 2420853535
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$22.90 |
| Max. Negotiated Rate |
$103.06 |
| Rate for Payer: Adventist Health Commercial |
$22.90
|
| Rate for Payer: Blue Shield of California Commercial |
$91.84
|
| Rate for Payer: Blue Shield of California EPN |
$57.71
|
| Rate for Payer: Cash Price |
$51.53
|
| Rate for Payer: Central Health Plan Commercial |
$91.61
|
| Rate for Payer: Cigna of CA HMO |
$80.16
|
| Rate for Payer: Cigna of CA PPO |
$80.16
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.80
|
| Rate for Payer: EPIC Health Plan Senior |
$45.80
|
| Rate for Payer: Galaxy Health WC |
$97.33
|
| Rate for Payer: Global Benefits Group Commercial |
$68.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.90
|
| Rate for Payer: Multiplan Commercial |
$85.88
|
| Rate for Payer: Networks By Design Commercial |
$74.43
|
| Rate for Payer: Prime Health Services Commercial |
$97.33
|
|
|
GANCICLOVIR 0.15 % EYE GEL [104575]
|
Facility
|
OP
|
$114.51
|
|
|
Service Code
|
NDC 2420853535
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$22.90 |
| Max. Negotiated Rate |
$103.06 |
| Rate for Payer: Adventist Health Commercial |
$22.90
|
| Rate for Payer: Aetna of CA HMO/PPO |
$69.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$97.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$62.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$85.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$55.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$66.61
|
| Rate for Payer: Blue Shield of California Commercial |
$72.60
|
| Rate for Payer: Blue Shield of California EPN |
$45.69
|
| Rate for Payer: Cash Price |
$51.53
|
| Rate for Payer: Central Health Plan Commercial |
$91.61
|
| Rate for Payer: Cigna of CA HMO |
$80.16
|
| Rate for Payer: Cigna of CA PPO |
$80.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$97.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$97.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$97.33
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$80.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$45.80
|
| Rate for Payer: EPIC Health Plan Senior |
$45.80
|
| Rate for Payer: Galaxy Health WC |
$97.33
|
| Rate for Payer: Global Benefits Group Commercial |
$68.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$103.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$72.71
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$41.57
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$67.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$22.90
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$80.16
|
| Rate for Payer: Multiplan Commercial |
$85.88
|
| Rate for Payer: Networks By Design Commercial |
$74.43
|
| Rate for Payer: Prime Health Services Commercial |
$97.33
|
| Rate for Payer: Riverside University Health System MISP |
$45.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$68.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$68.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$57.26
|
| Rate for Payer: United Healthcare All Other HMO |
$57.26
|
| Rate for Payer: United Healthcare HMO Rider |
$57.26
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$57.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$97.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$97.33
|
| Rate for Payer: Vantage Medical Group Senior |
$97.33
|
|
|
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION [10101]
|
Facility
|
IP
|
$82.08
|
|
|
Service Code
|
HCPCS J1570
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$16.42 |
| Max. Negotiated Rate |
$73.87 |
| Rate for Payer: Adventist Health Commercial |
$16.42
|
| Rate for Payer: Adventist Health Commercial |
$23.34
|
| Rate for Payer: Blue Shield of California Commercial |
$65.83
|
| Rate for Payer: Blue Shield of California Commercial |
$93.61
|
| Rate for Payer: Blue Shield of California EPN |
$58.83
|
| Rate for Payer: Blue Shield of California EPN |
$41.37
|
| Rate for Payer: Cash Price |
$36.94
|
| Rate for Payer: Cash Price |
$52.52
|
| Rate for Payer: Central Health Plan Commercial |
$65.66
|
| Rate for Payer: Central Health Plan Commercial |
$93.38
|
| Rate for Payer: Cigna of CA HMO |
$81.70
|
| Rate for Payer: Cigna of CA HMO |
$57.46
|
| Rate for Payer: Cigna of CA PPO |
$81.70
|
| Rate for Payer: Cigna of CA PPO |
$57.46
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$81.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.83
|
| Rate for Payer: EPIC Health Plan Senior |
$46.69
|
| Rate for Payer: EPIC Health Plan Senior |
$32.83
|
| Rate for Payer: Galaxy Health WC |
$69.77
|
| Rate for Payer: Galaxy Health WC |
$99.21
|
| Rate for Payer: Global Benefits Group Commercial |
$70.03
|
| Rate for Payer: Global Benefits Group Commercial |
$49.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.87
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$68.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.34
|
| Rate for Payer: Multiplan Commercial |
$87.54
|
| Rate for Payer: Multiplan Commercial |
$61.56
|
| Rate for Payer: Networks By Design Commercial |
$58.36
|
| Rate for Payer: Networks By Design Commercial |
$41.04
|
| Rate for Payer: Prime Health Services Commercial |
$69.77
|
| Rate for Payer: Prime Health Services Commercial |
$99.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.80
|
| Rate for Payer: United Healthcare All Other HMO |
$29.98
|
| Rate for Payer: United Healthcare All Other HMO |
$42.64
|
| Rate for Payer: United Healthcare HMO Rider |
$41.72
|
| Rate for Payer: United Healthcare HMO Rider |
$29.34
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.88
|
|
|
GANCICLOVIR SODIUM 500 MG INTRAVENOUS SOLUTION [10101]
|
Facility
|
OP
|
$116.72
|
|
|
Service Code
|
HCPCS J1570
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.34 |
| Max. Negotiated Rate |
$198.86 |
| Rate for Payer: Adventist Health Commercial |
$23.34
|
| Rate for Payer: Adventist Health Commercial |
$16.42
|
| Rate for Payer: Aetna of CA HMO/PPO |
$198.86
|
| Rate for Payer: Aetna of CA HMO/PPO |
$198.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$99.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$69.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$45.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$64.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$61.56
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$87.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$63.88
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$63.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.72
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$79.72
|
| Rate for Payer: Blue Shield of California Commercial |
$95.04
|
| Rate for Payer: Blue Shield of California Commercial |
$95.04
|
| Rate for Payer: Blue Shield of California EPN |
$86.40
|
| Rate for Payer: Blue Shield of California EPN |
$86.40
|
| Rate for Payer: Cash Price |
$52.52
|
| Rate for Payer: Cash Price |
$36.94
|
| Rate for Payer: Cash Price |
$52.52
|
| Rate for Payer: Cash Price |
$36.94
|
| Rate for Payer: Central Health Plan Commercial |
$65.66
|
| Rate for Payer: Central Health Plan Commercial |
$93.38
|
| Rate for Payer: Cigna of CA HMO |
$81.70
|
| Rate for Payer: Cigna of CA HMO |
$57.46
|
| Rate for Payer: Cigna of CA PPO |
$81.70
|
| Rate for Payer: Cigna of CA PPO |
$57.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$69.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$99.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$99.21
|
| Rate for Payer: Dignity Health Medi-Cal |
$69.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$69.77
|
| Rate for Payer: Dignity Health Medicare Advantage |
$99.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$81.70
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$57.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$46.69
|
| Rate for Payer: EPIC Health Plan Senior |
$32.83
|
| Rate for Payer: EPIC Health Plan Senior |
$46.69
|
| Rate for Payer: Galaxy Health WC |
$99.21
|
| Rate for Payer: Galaxy Health WC |
$69.77
|
| Rate for Payer: Global Benefits Group Commercial |
$49.25
|
| Rate for Payer: Global Benefits Group Commercial |
$70.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$105.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$73.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.46
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$31.46
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$52.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$74.12
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$42.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$29.80
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$48.43
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$68.86
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.42
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$23.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$57.46
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$81.70
|
| Rate for Payer: Multiplan Commercial |
$61.56
|
| Rate for Payer: Multiplan Commercial |
$87.54
|
| Rate for Payer: Networks By Design Commercial |
$41.04
|
| Rate for Payer: Networks By Design Commercial |
$58.36
|
| Rate for Payer: Prime Health Services Commercial |
$69.77
|
| Rate for Payer: Prime Health Services Commercial |
$99.21
|
| Rate for Payer: Riverside University Health System MISP |
$46.69
|
| Rate for Payer: Riverside University Health System MISP |
$32.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$49.25
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$70.03
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$49.25
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$70.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$43.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$30.80
|
| Rate for Payer: United Healthcare All Other HMO |
$29.98
|
| Rate for Payer: United Healthcare All Other HMO |
$42.64
|
| Rate for Payer: United Healthcare HMO Rider |
$29.34
|
| Rate for Payer: United Healthcare HMO Rider |
$41.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$26.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$38.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$99.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$69.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$99.21
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$69.77
|
| Rate for Payer: Vantage Medical Group Senior |
$69.77
|
| Rate for Payer: Vantage Medical Group Senior |
$99.21
|
|
|
GASTRIC FUNDOPLICATION
|
Facility
|
IP
|
$52,808.03
|
|
|
Service Code
|
APR-DRG 2324
|
| Min. Negotiated Rate |
$33,352.44 |
| Max. Negotiated Rate |
$52,808.03 |
| Rate for Payer: Adventist Health Medi-Cal |
$33,352.44
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$39,744.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$52,808.03
|
|
|
GASTRIC FUNDOPLICATION
|
Facility
|
IP
|
$33,945.15
|
|
|
Service Code
|
APR-DRG 2323
|
| Min. Negotiated Rate |
$21,439.04 |
| Max. Negotiated Rate |
$33,945.15 |
| Rate for Payer: Adventist Health Medi-Cal |
$21,439.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$25,548.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$33,945.15
|
|
|
GASTRIC FUNDOPLICATION
|
Facility
|
IP
|
$21,878.14
|
|
|
Service Code
|
APR-DRG 2322
|
| Min. Negotiated Rate |
$13,817.77 |
| Max. Negotiated Rate |
$21,878.14 |
| Rate for Payer: Adventist Health Medi-Cal |
$13,817.77
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$16,466.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$21,878.14
|
|
|
GASTRIC FUNDOPLICATION
|
Facility
|
IP
|
$18,635.29
|
|
|
Service Code
|
APR-DRG 2321
|
| Min. Negotiated Rate |
$11,769.66 |
| Max. Negotiated Rate |
$18,635.29 |
| Rate for Payer: Adventist Health Medi-Cal |
$11,769.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$14,025.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$18,635.29
|
|
|
GASTROCNEMIUS RECESSION (EG, STRAYER PROCEDURE)
|
Facility
|
OP
|
$27,467.00
|
|
|
Service Code
|
CPT 27687
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$565.43 |
| Max. Negotiated Rate |
$27,467.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$4,208.34
|
| Rate for Payer: Aetna of CA HMO/PPO |
$27,467.00
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4,208.34
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$5,806.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8,074.00
|
| Rate for Payer: Anthem Blue Cross of CA Workers' Comp |
$6,568.63
|
| Rate for Payer: Blue Shield of California Commercial |
$5,036.70
|
| Rate for Payer: Blue Shield of California EPN |
$3,165.61
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$4,629.17
|
| Rate for Payer: Dignity Health Medicare Advantage |
$4,208.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,943.76
|
| Rate for Payer: EPIC Health Plan Senior |
$4,629.17
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$6,901.68
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$565.43
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$624.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$5,891.68
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$5,639.18
|
| Rate for Payer: Multiplan WC |
$6,568.63
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$4,208.34
|
| Rate for Payer: Preferred Health Network WC |
$6,702.68
|
| Rate for Payer: Prime Health Services Medicare |
$4,460.84
|
| Rate for Payer: Prime Health Services WC |
$6,501.60
|
| Rate for Payer: Riverside University Health System MISP |
$4,629.17
|
| Rate for Payer: United Healthcare All Other HMO |
$20,902.00
|
| Rate for Payer: United Healthcare HMO Rider |
$13,066.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$11,971.00
|
| Rate for Payer: Upland Medical Group Pediatric |
$4,208.34
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$6,312.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4,629.17
|
| Rate for Payer: Vantage Medical Group Senior |
$4,208.34
|
|
|
GASTROINTESTINAL HEMORRHAGE WITH CC
|
Facility
|
IP
|
$25,811.04
|
|
|
Service Code
|
MSDRG 378
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$25,811.04 |
| Rate for Payer: Aetna of CA HMO/PPO |
$25,811.04
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16,672.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$23,342.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$23,805.29
|
| Rate for Payer: EPIC Health Plan Senior |
$15,870.19
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$14,427.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$20,198.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$19,332.78
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$14,427.45
|
| Rate for Payer: Prime Health Services Medicare |
$15,293.10
|
| 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
|
|
|
GASTROINTESTINAL HEMORRHAGE WITH MCC
|
Facility
|
IP
|
$48,111.13
|
|
|
Service Code
|
MSDRG 377
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$48,111.13 |
| Rate for Payer: Aetna of CA HMO/PPO |
$48,111.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$31,077.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$43,510.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$43,087.23
|
| Rate for Payer: EPIC Health Plan Senior |
$28,724.82
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,113.47
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$36,558.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$34,992.05
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$26,113.47
|
| Rate for Payer: Prime Health Services Medicare |
$27,680.28
|
| 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
|
|
|
GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC
|
Facility
|
IP
|
$16,591.50
|
|
|
Service Code
|
MSDRG 379
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$16,591.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$16,591.50
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$10,717.43
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$15,004.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$15,833.55
|
| Rate for Payer: EPIC Health Plan Senior |
$10,555.70
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$9,596.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$13,434.53
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12,858.76
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$9,596.09
|
| Rate for Payer: Prime Health Services Medicare |
$10,171.86
|
| 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
|
|
|
GASTROINTESTINAL OBSTRUCTION WITH CC
|
Facility
|
IP
|
$20,786.75
|
|
|
Service Code
|
MSDRG 389
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$20,786.75 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,786.75
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$13,427.39
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$18,798.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$19,461.02
|
| Rate for Payer: EPIC Health Plan Senior |
$12,974.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11,794.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$16,512.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$15,804.71
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$11,794.56
|
| Rate for Payer: Prime Health Services Medicare |
$12,502.23
|
| 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
|
|
|
GASTROINTESTINAL OBSTRUCTION WITH MCC
|
Facility
|
IP
|
$38,867.90
|
|
|
Service Code
|
MSDRG 388
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$38,867.90 |
| Rate for Payer: Aetna of CA HMO/PPO |
$38,867.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$25,107.08
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$35,150.79
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,094.99
|
| Rate for Payer: EPIC Health Plan Senior |
$23,396.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$21,269.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$29,777.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$28,501.38
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$21,269.69
|
| Rate for Payer: Prime Health Services Medicare |
$22,545.87
|
| 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
|
|
|
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC
|
Facility
|
IP
|
$14,317.54
|
|
|
Service Code
|
MSDRG 390
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$14,317.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$14,317.54
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9,248.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$12,948.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$13,867.36
|
| Rate for Payer: EPIC Health Plan Senior |
$9,244.91
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$8,404.46
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$11,766.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$11,261.98
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$8,404.46
|
| Rate for Payer: Prime Health Services Medicare |
$8,908.73
|
| 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
|
|
|
GASTROINTESTINAL VASCULAR INSUFFICIENCY
|
Facility
|
IP
|
$9,799.04
|
|
|
Service Code
|
APR-DRG 2461
|
| Min. Negotiated Rate |
$6,188.87 |
| Max. Negotiated Rate |
$9,799.04 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,188.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$7,375.07
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9,799.04
|
|
|
GASTROINTESTINAL VASCULAR INSUFFICIENCY
|
Facility
|
IP
|
$17,150.83
|
|
|
Service Code
|
APR-DRG 2463
|
| Min. Negotiated Rate |
$10,832.10 |
| Max. Negotiated Rate |
$17,150.83 |
| Rate for Payer: Adventist Health Medi-Cal |
$10,832.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$12,908.25
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17,150.83
|
|
|
GASTROINTESTINAL VASCULAR INSUFFICIENCY
|
Facility
|
IP
|
$25,187.44
|
|
|
Service Code
|
APR-DRG 2464
|
| Min. Negotiated Rate |
$15,907.86 |
| Max. Negotiated Rate |
$25,187.44 |
| Rate for Payer: Adventist Health Medi-Cal |
$15,907.86
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18,956.87
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$25,187.44
|
|
|
GASTROINTESTINAL VASCULAR INSUFFICIENCY
|
Facility
|
IP
|
$12,028.75
|
|
|
Service Code
|
APR-DRG 2462
|
| Min. Negotiated Rate |
$7,597.10 |
| Max. Negotiated Rate |
$12,028.75 |
| Rate for Payer: Adventist Health Medi-Cal |
$7,597.10
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$9,053.22
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$12,028.75
|
|
|
GELATIN ABSORBABLE EYE FILM [28028]
|
Facility
|
OP
|
$268.54
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$53.71 |
| Max. Negotiated Rate |
$241.69 |
| Rate for Payer: Adventist Health Commercial |
$53.71
|
| Rate for Payer: Aetna of CA HMO/PPO |
$163.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$228.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$147.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$201.41
|
| Rate for Payer: Blue Shield of California Commercial |
$170.25
|
| Rate for Payer: Blue Shield of California EPN |
$107.15
|
| Rate for Payer: Cash Price |
$120.84
|
| Rate for Payer: Central Health Plan Commercial |
$214.83
|
| Rate for Payer: Cigna of CA HMO |
$187.98
|
| Rate for Payer: Cigna of CA PPO |
$187.98
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$228.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$228.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$228.26
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$187.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.42
|
| Rate for Payer: EPIC Health Plan Senior |
$107.42
|
| Rate for Payer: Galaxy Health WC |
$228.26
|
| Rate for Payer: Global Benefits Group Commercial |
$161.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$241.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$170.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$158.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.71
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$187.98
|
| Rate for Payer: Multiplan Commercial |
$201.41
|
| Rate for Payer: Networks By Design Commercial |
$134.27
|
| Rate for Payer: Prime Health Services Commercial |
$228.26
|
| Rate for Payer: Riverside University Health System MISP |
$107.42
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$161.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$161.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$100.78
|
| Rate for Payer: United Healthcare All Other HMO |
$98.10
|
| Rate for Payer: United Healthcare HMO Rider |
$95.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$87.95
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$228.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$228.26
|
| Rate for Payer: Vantage Medical Group Senior |
$228.26
|
|
|
GELATIN ABSORBABLE EYE FILM [28028]
|
Facility
|
IP
|
$268.54
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$53.71 |
| Max. Negotiated Rate |
$241.69 |
| Rate for Payer: Adventist Health Commercial |
$53.71
|
| Rate for Payer: Blue Shield of California Commercial |
$215.37
|
| Rate for Payer: Blue Shield of California EPN |
$135.34
|
| Rate for Payer: Cash Price |
$120.84
|
| Rate for Payer: Central Health Plan Commercial |
$214.83
|
| Rate for Payer: Cigna of CA HMO |
$187.98
|
| Rate for Payer: Cigna of CA PPO |
$187.98
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$187.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$107.42
|
| Rate for Payer: EPIC Health Plan Senior |
$107.42
|
| Rate for Payer: Galaxy Health WC |
$228.26
|
| Rate for Payer: Global Benefits Group Commercial |
$161.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$241.69
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$170.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$158.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$53.71
|
| Rate for Payer: Multiplan Commercial |
$201.41
|
| Rate for Payer: Networks By Design Commercial |
$134.27
|
| Rate for Payer: Prime Health Services Commercial |
$228.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$100.78
|
| Rate for Payer: United Healthcare All Other HMO |
$98.10
|
| Rate for Payer: United Healthcare HMO Rider |
$95.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$87.95
|
|
|
GELATIN ABSORBABLE IMPLANT FILM [111340]
|
Facility
|
IP
|
$2,692.28
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$538.46 |
| Max. Negotiated Rate |
$2,423.05 |
| Rate for Payer: Adventist Health Commercial |
$538.46
|
| Rate for Payer: Blue Shield of California Commercial |
$2,159.21
|
| Rate for Payer: Blue Shield of California EPN |
$1,356.91
|
| Rate for Payer: Cash Price |
$1,211.53
|
| Rate for Payer: Central Health Plan Commercial |
$2,153.82
|
| Rate for Payer: Cigna of CA HMO |
$1,884.60
|
| Rate for Payer: Cigna of CA PPO |
$1,884.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1,884.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$1,076.91
|
| Rate for Payer: EPIC Health Plan Senior |
$1,076.91
|
| Rate for Payer: Galaxy Health WC |
$2,288.44
|
| Rate for Payer: Global Benefits Group Commercial |
$1,615.37
|
| Rate for Payer: Health Management Network EPO/PPO |
$2,423.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1,709.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1,588.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$538.46
|
| Rate for Payer: Multiplan Commercial |
$2,019.21
|
| Rate for Payer: Networks By Design Commercial |
$1,346.14
|
| Rate for Payer: Prime Health Services Commercial |
$2,288.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,010.41
|
| Rate for Payer: United Healthcare All Other HMO |
$983.49
|
| Rate for Payer: United Healthcare HMO Rider |
$962.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$881.72
|
|
