|
DRONABINOL 5 MG CAPSULE [9905]
|
Facility
IP
|
$11.57
|
|
|
Service Code
|
NDC 0904-6746-04
|
| Hospital Charge Code |
1730005
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.31 |
| Max. Negotiated Rate |
$10.41 |
| Rate for Payer: Blue Shield of California Commercial |
$8.68
|
| Rate for Payer: Blue Shield of California EPN |
$6.18
|
| Rate for Payer: Cash Price |
$5.21
|
| Rate for Payer: Central Health Plan Commercial |
$9.26
|
| Rate for Payer: Cigna of CA HMO |
$8.10
|
| Rate for Payer: Cigna of CA PPO |
$8.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.63
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.63
|
| Rate for Payer: Galaxy Health WC |
$9.83
|
| Rate for Payer: Global Benefits Group Commercial |
$6.94
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.41
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.31
|
| Rate for Payer: Multiplan Commercial |
$8.68
|
| Rate for Payer: Networks By Design Commercial |
$5.78
|
| Rate for Payer: Prime Health Services Commercial |
$9.83
|
|
|
DRONEDARONE 400 MG TABLET [98329]
|
Facility
IP
|
$15.20
|
|
|
Service Code
|
NDC 0024-4142-60
|
| Hospital Charge Code |
1712418
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$13.68 |
| Rate for Payer: Blue Shield of California Commercial |
$11.40
|
| Rate for Payer: Blue Shield of California EPN |
$8.12
|
| Rate for Payer: Cash Price |
$6.84
|
| Rate for Payer: Central Health Plan Commercial |
$12.16
|
| Rate for Payer: Cigna of CA HMO |
$10.64
|
| Rate for Payer: Cigna of CA PPO |
$10.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.08
|
| Rate for Payer: Galaxy Health WC |
$12.92
|
| Rate for Payer: Global Benefits Group Commercial |
$9.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.68
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.04
|
| Rate for Payer: Multiplan Commercial |
$11.40
|
| Rate for Payer: Networks By Design Commercial |
$9.88
|
| Rate for Payer: Prime Health Services Commercial |
$12.92
|
|
|
DRONEDARONE 400 MG TABLET [98329]
|
Facility
OP
|
$15.20
|
|
|
Service Code
|
NDC 0024-4142-60
|
| Hospital Charge Code |
1712418
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.04 |
| Max. Negotiated Rate |
$13.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9.23
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$12.92
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$8.36
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.36
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.36
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.98
|
| Rate for Payer: BCBS Transplant Transplant |
$9.12
|
| Rate for Payer: Blue Shield of California Commercial |
$9.56
|
| Rate for Payer: Blue Shield of California EPN |
$7.43
|
| Rate for Payer: Cash Price |
$6.84
|
| Rate for Payer: Central Health Plan Commercial |
$12.16
|
| Rate for Payer: Cigna of CA HMO |
$10.64
|
| Rate for Payer: Cigna of CA PPO |
$10.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.08
|
| Rate for Payer: Galaxy Health WC |
$12.92
|
| Rate for Payer: Global Benefits Group Commercial |
$9.12
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.68
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$11.40
|
| Rate for Payer: IEHP medi-cal |
$5.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.04
|
| Rate for Payer: Multiplan Commercial |
$11.40
|
| Rate for Payer: Networks By Design Commercial |
$9.88
|
| Rate for Payer: Prime Health Services Commercial |
$12.92
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$9.12
|
| Rate for Payer: Riverside University Health MISP |
$6.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.12
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.60
|
| Rate for Payer: United Healthcare All Other HMO |
$7.60
|
| Rate for Payer: United Healthcare HMO Rider |
$7.60
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.92
|
| Rate for Payer: Vantage Medical Group Senior |
$12.92
|
|
|
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION [2654]
|
Facility
OP
|
$5.37
|
|
|
Service Code
|
CPT J1790
|
| Hospital Charge Code |
NDG2654
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$54.67 |
| Rate for Payer: Aetna of CA HMO/PPO |
$54.67
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$4.56
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2.95
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$9.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.67
|
| Rate for Payer: BCBS Transplant Transplant |
$3.22
|
| Rate for Payer: Blue Shield of California Commercial |
$9.86
|
| Rate for Payer: Blue Shield of California EPN |
$8.96
|
| Rate for Payer: Cash Price |
$2.42
|
| Rate for Payer: Cash Price |
$2.42
|
| Rate for Payer: Central Health Plan Commercial |
$4.30
|
| Rate for Payer: Cigna of CA HMO |
$3.76
|
| Rate for Payer: Cigna of CA PPO |
$3.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.15
|
| Rate for Payer: Galaxy Health WC |
$4.56
|
| Rate for Payer: Global Benefits Group Commercial |
$3.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.83
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$4.03
|
| Rate for Payer: IEHP medi-cal |
$1.88
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.07
|
| Rate for Payer: Multiplan Commercial |
$4.03
|
| Rate for Payer: Networks By Design Commercial |
$2.68
|
| Rate for Payer: Prime Health Services Commercial |
$4.56
|
| Rate for Payer: Riverside University Health MISP |
$2.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.68
|
| Rate for Payer: United Healthcare All Other HMO |
$2.68
|
| Rate for Payer: United Healthcare HMO Rider |
$2.68
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.68
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.56
|
| Rate for Payer: Vantage Medical Group Senior |
$4.56
|
|
|
DROPERIDOL 2.5 MG/ML INJECTION SOLUTION [2654]
|
Facility
IP
|
$5.37
|
|
|
Service Code
|
CPT J1790
|
| Hospital Charge Code |
NDG2654
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$4.83 |
| Rate for Payer: Blue Shield of California Commercial |
$4.03
|
| Rate for Payer: Blue Shield of California EPN |
$2.87
|
| Rate for Payer: Cash Price |
$2.42
|
| Rate for Payer: Central Health Plan Commercial |
$4.30
|
| Rate for Payer: Cigna of CA HMO |
$3.76
|
| Rate for Payer: Cigna of CA PPO |
$3.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.15
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.15
|
| Rate for Payer: Galaxy Health WC |
$4.56
|
| Rate for Payer: Global Benefits Group Commercial |
$3.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$4.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$3.58
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.07
|
| Rate for Payer: Multiplan Commercial |
$4.03
|
| Rate for Payer: Networks By Design Commercial |
$2.68
|
| Rate for Payer: Prime Health Services Commercial |
$4.56
|
|
|
DROXIDOPA 100 MG CAPSULE [206920]
|
Facility
OP
|
$1.66
|
|
|
Service Code
|
NDC 0054-0532-22
|
| Hospital Charge Code |
ERX206920
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$1.49 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.01
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.41
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.91
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.91
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.98
|
| Rate for Payer: BCBS Transplant Transplant |
$1.00
|
| Rate for Payer: Blue Shield of California Commercial |
$1.04
|
| Rate for Payer: Blue Shield of California EPN |
$0.81
|
| Rate for Payer: Cash Price |
$0.75
|
| 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: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$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: Health Plan of Nevada - Sierra Transplant Other |
$1.24
|
| Rate for Payer: IEHP medi-cal |
$0.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: Multiplan Commercial |
$1.24
|
| Rate for Payer: Networks By Design Commercial |
$1.08
|
| Rate for Payer: Prime Health Services Commercial |
$1.41
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1.00
|
| Rate for Payer: Riverside University Health 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 Medi-Cal |
$1.41
|
| Rate for Payer: Vantage Medical Group Senior |
$1.41
|
|
|
DROXIDOPA 100 MG CAPSULE [206920]
|
Facility
IP
|
$1.66
|
|
|
Service Code
|
NDC 0054-0532-22
|
| Hospital Charge Code |
ERX206920
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$1.49 |
| Rate for Payer: Blue Shield of California Commercial |
$1.24
|
| Rate for Payer: Blue Shield of California EPN |
$0.89
|
| Rate for Payer: Cash Price |
$0.75
|
| 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: 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: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: Multiplan Commercial |
$1.24
|
| Rate for Payer: Networks By Design Commercial |
$1.08
|
| Rate for Payer: Prime Health Services Commercial |
$1.41
|
|
|
DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
|
Facility
IP
|
$2,985.87
|
|
|
Service Code
|
APR-DRG 7701
|
| Min. Negotiated Rate |
$2,505.62 |
| Max. Negotiated Rate |
$2,985.87 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,505.62
|
| Rate for Payer: IEHP medi-cal |
$2,985.87
|
|
|
DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
|
Facility
IP
|
$4,568.89
|
|
|
Service Code
|
APR-DRG 7702
|
| Min. Negotiated Rate |
$3,834.04 |
| Max. Negotiated Rate |
$4,568.89 |
| Rate for Payer: Adventist Health Medi-Cal |
$3,834.04
|
| Rate for Payer: IEHP medi-cal |
$4,568.89
|
|
|
DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
|
Facility
IP
|
$14,735.78
|
|
|
Service Code
|
APR-DRG 7704
|
| Min. Negotiated Rate |
$12,365.69 |
| Max. Negotiated Rate |
$14,735.78 |
| Rate for Payer: Adventist Health Medi-Cal |
$12,365.69
|
| Rate for Payer: IEHP medi-cal |
$14,735.78
|
|
|
DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE
|
Facility
IP
|
$7,237.07
|
|
|
Service Code
|
APR-DRG 7703
|
| Min. Negotiated Rate |
$6,073.07 |
| Max. Negotiated Rate |
$7,237.07 |
| Rate for Payer: Adventist Health Medi-Cal |
$6,073.07
|
| Rate for Payer: IEHP medi-cal |
$7,237.07
|
|
|
Drug-induced sleep endoscopy, with dynamic evaluation of velum, pharynx, tongue base, and larynx for evaluation of sleep-disordered breathing, flexible, diagnostic
|
Facility
OP
|
$397,400.00
|
|
|
Service Code
|
CPT 42975
|
|
Hospital Revenue Code
|
360
|
| Min. Negotiated Rate |
$951.00 |
| Max. Negotiated Rate |
$397,400.00 |
| Rate for Payer: Adventist Health Medi-Cal |
$2,120.62
|
| Rate for Payer: Aetna of CA HMO/PPO |
$6,248.00
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$2,120.62
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$397,400.00
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4,846.00
|
| Rate for Payer: Blue Shield of California Commercial |
$7,609.02
|
| Rate for Payer: Blue Shield of California EPN |
$5,465.14
|
| Rate for Payer: Caremore Medicare Advantage |
$2,120.62
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3,180.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,862.84
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$2,120.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$2,120.62
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3,477.82
|
| Rate for Payer: IEHP medi-cal |
$3,499.02
|
| Rate for Payer: IEHP Medicare Advantage |
$2,120.62
|
| Rate for Payer: Innovage PACE Commercial |
$3,180.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$2,120.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2,841.63
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2,841.63
|
| Rate for Payer: Prime Health Services Medicare |
$2,247.86
|
| Rate for Payer: Riverside University Health MISP |
$2,332.68
|
| Rate for Payer: United Healthcare All Other Commercial |
$1,834.00
|
| Rate for Payer: United Healthcare All Other HMO |
$1,517.00
|
| Rate for Payer: United Healthcare HMO Rider |
$1,041.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$951.00
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3,180.93
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2,332.68
|
| Rate for Payer: Vantage Medical Group Senior |
$2,120.62
|
|
|
DTAP-POLIO-HIB CONJ-TET(PF) 15 LF-48MCG-5 LF-62 DU-10MCG/ 0.5ML IM KIT [227486]
|
Facility
IP
|
$129.06
|
|
|
Service Code
|
CPT 90698
|
| Hospital Charge Code |
ERX227486
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.81 |
| Max. Negotiated Rate |
$116.15 |
| Rate for Payer: Blue Shield of California Commercial |
$96.80
|
| Rate for Payer: Blue Shield of California EPN |
$68.92
|
| Rate for Payer: Cash Price |
$58.08
|
| Rate for Payer: Central Health Plan Commercial |
$103.25
|
| Rate for Payer: Cigna of CA HMO |
$90.34
|
| Rate for Payer: Cigna of CA PPO |
$90.34
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$51.62
|
| Rate for Payer: Galaxy Health WC |
$109.70
|
| Rate for Payer: Global Benefits Group Commercial |
$77.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$116.15
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$86.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.81
|
| Rate for Payer: Multiplan Commercial |
$96.80
|
| Rate for Payer: Networks By Design Commercial |
$64.53
|
| Rate for Payer: Prime Health Services Commercial |
$109.70
|
|
|
DTAP-POLIO-HIB CONJ-TET(PF) 15 LF-48MCG-5 LF-62 DU-10MCG/ 0.5ML IM KIT [227486]
|
Facility
OP
|
$129.06
|
|
|
Service Code
|
CPT 90698
|
| Hospital Charge Code |
ERX227486
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$25.81 |
| Max. Negotiated Rate |
$725.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$725.24
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$109.70
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$70.98
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$70.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$96.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$105.30
|
| Rate for Payer: BCBS Transplant Transplant |
$77.44
|
| Rate for Payer: Blue Shield of California Commercial |
$130.96
|
| Rate for Payer: Blue Shield of California EPN |
$119.05
|
| Rate for Payer: Cash Price |
$58.08
|
| Rate for Payer: Cash Price |
$58.08
|
| Rate for Payer: Central Health Plan Commercial |
$103.25
|
| Rate for Payer: Cigna of CA HMO |
$90.34
|
| Rate for Payer: Cigna of CA PPO |
$90.34
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$109.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$51.62
|
| Rate for Payer: EPIC Health Plan Transplant |
$51.62
|
| Rate for Payer: Galaxy Health WC |
$109.70
|
| Rate for Payer: Global Benefits Group Commercial |
$77.44
|
| Rate for Payer: Health Management Network EPO/PPO |
$116.15
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$96.80
|
| Rate for Payer: IEHP medi-cal |
$45.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$86.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$25.81
|
| Rate for Payer: Multiplan Commercial |
$96.80
|
| Rate for Payer: Networks By Design Commercial |
$64.53
|
| Rate for Payer: Prime Health Services Commercial |
$109.70
|
| Rate for Payer: Riverside University Health MISP |
$51.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$77.44
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$77.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$64.53
|
| Rate for Payer: United Healthcare All Other HMO |
$64.53
|
| Rate for Payer: United Healthcare HMO Rider |
$64.53
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$64.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$109.70
|
| Rate for Payer: Vantage Medical Group Senior |
$109.70
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [39275]
|
Facility
OP
|
$2.12
|
|
|
Service Code
|
NDC 68084-675-11
|
| Hospital Charge Code |
1711839
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.25
|
| Rate for Payer: BCBS Transplant Transplant |
$1.27
|
| Rate for Payer: Blue Shield of California Commercial |
$1.33
|
| Rate for Payer: Blue Shield of California EPN |
$1.04
|
| Rate for Payer: Cash Price |
$0.95
|
| Rate for Payer: Central Health Plan Commercial |
$1.70
|
| Rate for Payer: Cigna of CA HMO |
$1.48
|
| Rate for Payer: Cigna of CA PPO |
$1.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.85
|
| Rate for Payer: Galaxy Health WC |
$1.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.91
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.59
|
| Rate for Payer: IEHP medi-cal |
$0.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: Multiplan Commercial |
$1.59
|
| Rate for Payer: Networks By Design Commercial |
$1.38
|
| Rate for Payer: Prime Health Services Commercial |
$1.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1.27
|
| Rate for Payer: Riverside University Health MISP |
$0.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.06
|
| Rate for Payer: United Healthcare All Other HMO |
$1.06
|
| Rate for Payer: United Healthcare HMO Rider |
$1.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1.80
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [39275]
|
Facility
IP
|
$2.12
|
|
|
Service Code
|
NDC 68084-675-21
|
| Hospital Charge Code |
1711839
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.91 |
| Rate for Payer: Blue Shield of California Commercial |
$1.59
|
| Rate for Payer: Blue Shield of California EPN |
$1.13
|
| Rate for Payer: Cash Price |
$0.95
|
| Rate for Payer: Central Health Plan Commercial |
$1.70
|
| Rate for Payer: Cigna of CA HMO |
$1.48
|
| Rate for Payer: Cigna of CA PPO |
$1.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.85
|
| Rate for Payer: Galaxy Health WC |
$1.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: Multiplan Commercial |
$1.59
|
| Rate for Payer: Networks By Design Commercial |
$1.38
|
| Rate for Payer: Prime Health Services Commercial |
$1.80
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [39275]
|
Facility
OP
|
$0.59
|
|
|
Service Code
|
NDC 60505-2995-6
|
| Hospital Charge Code |
1711839
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.53 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.36
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.32
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.35
|
| Rate for Payer: BCBS Transplant Transplant |
$0.35
|
| Rate for Payer: Blue Shield of California Commercial |
$0.37
|
| Rate for Payer: Blue Shield of California EPN |
$0.29
|
| Rate for Payer: Cash Price |
$0.27
|
| Rate for Payer: Central Health Plan Commercial |
$0.47
|
| Rate for Payer: Cigna of CA HMO |
$0.41
|
| Rate for Payer: Cigna of CA PPO |
$0.41
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.50
|
| Rate for Payer: Global Benefits Group Commercial |
$0.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.53
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.44
|
| Rate for Payer: IEHP medi-cal |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Commercial |
$0.44
|
| Rate for Payer: Networks By Design Commercial |
$0.38
|
| Rate for Payer: Prime Health Services Commercial |
$0.50
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.35
|
| Rate for Payer: Riverside University Health MISP |
$0.24
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.35
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.30
|
| Rate for Payer: United Healthcare All Other HMO |
$0.30
|
| Rate for Payer: United Healthcare HMO Rider |
$0.30
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.50
|
| Rate for Payer: Vantage Medical Group Senior |
$0.50
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [39275]
|
Facility
OP
|
$2.12
|
|
|
Service Code
|
NDC 68084-675-21
|
| Hospital Charge Code |
1711839
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.91 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1.29
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.80
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.17
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.17
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.03
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.25
|
| Rate for Payer: BCBS Transplant Transplant |
$1.27
|
| Rate for Payer: Blue Shield of California Commercial |
$1.33
|
| Rate for Payer: Blue Shield of California EPN |
$1.04
|
| Rate for Payer: Cash Price |
$0.95
|
| Rate for Payer: Central Health Plan Commercial |
$1.70
|
| Rate for Payer: Cigna of CA HMO |
$1.48
|
| Rate for Payer: Cigna of CA PPO |
$1.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.85
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.85
|
| Rate for Payer: Galaxy Health WC |
$1.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.91
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$1.59
|
| Rate for Payer: IEHP medi-cal |
$0.74
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: Multiplan Commercial |
$1.59
|
| Rate for Payer: Networks By Design Commercial |
$1.38
|
| Rate for Payer: Prime Health Services Commercial |
$1.80
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$1.27
|
| Rate for Payer: Riverside University Health MISP |
$0.85
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.27
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.06
|
| Rate for Payer: United Healthcare All Other HMO |
$1.06
|
| Rate for Payer: United Healthcare HMO Rider |
$1.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.80
|
| Rate for Payer: Vantage Medical Group Senior |
$1.80
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [39275]
|
Facility
OP
|
$0.56
|
|
|
Service Code
|
NDC 68001-413-06
|
| Hospital Charge Code |
1711839
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.50 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.34
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.48
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.31
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.31
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.33
|
| Rate for Payer: BCBS Transplant Transplant |
$0.34
|
| Rate for Payer: Blue Shield of California Commercial |
$0.35
|
| Rate for Payer: Blue Shield of California EPN |
$0.27
|
| Rate for Payer: Cash Price |
$0.25
|
| Rate for Payer: Central Health Plan Commercial |
$0.45
|
| Rate for Payer: Cigna of CA HMO |
$0.39
|
| Rate for Payer: Cigna of CA PPO |
$0.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.22
|
| Rate for Payer: Galaxy Health WC |
$0.48
|
| Rate for Payer: Global Benefits Group Commercial |
$0.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.50
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.42
|
| Rate for Payer: IEHP medi-cal |
$0.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: Multiplan Commercial |
$0.42
|
| Rate for Payer: Networks By Design Commercial |
$0.36
|
| Rate for Payer: Prime Health Services Commercial |
$0.48
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.34
|
| Rate for Payer: Riverside University Health MISP |
$0.22
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.34
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.34
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.28
|
| Rate for Payer: United Healthcare All Other HMO |
$0.28
|
| Rate for Payer: United Healthcare HMO Rider |
$0.28
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.48
|
| Rate for Payer: Vantage Medical Group Senior |
$0.48
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [39275]
|
Facility
IP
|
$0.56
|
|
|
Service Code
|
NDC 68001-413-06
|
| Hospital Charge Code |
1711839
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.50 |
| Rate for Payer: Blue Shield of California Commercial |
$0.42
|
| Rate for Payer: Blue Shield of California EPN |
$0.30
|
| Rate for Payer: Cash Price |
$0.25
|
| Rate for Payer: Central Health Plan Commercial |
$0.45
|
| Rate for Payer: Cigna of CA HMO |
$0.39
|
| Rate for Payer: Cigna of CA PPO |
$0.39
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.22
|
| Rate for Payer: Galaxy Health WC |
$0.48
|
| Rate for Payer: Global Benefits Group Commercial |
$0.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: Multiplan Commercial |
$0.42
|
| Rate for Payer: Networks By Design Commercial |
$0.36
|
| Rate for Payer: Prime Health Services Commercial |
$0.48
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [39275]
|
Facility
OP
|
$0.36
|
|
|
Service Code
|
NDC 51991-746-90
|
| Hospital Charge Code |
1711839
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.32 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.22
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$0.31
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$0.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.21
|
| Rate for Payer: BCBS Transplant Transplant |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.23
|
| Rate for Payer: Blue Shield of California EPN |
$0.18
|
| Rate for Payer: Cash Price |
$0.16
|
| Rate for Payer: Central Health Plan Commercial |
$0.29
|
| Rate for Payer: Cigna of CA HMO |
$0.25
|
| Rate for Payer: Cigna of CA PPO |
$0.25
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.14
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.14
|
| Rate for Payer: Galaxy Health WC |
$0.31
|
| Rate for Payer: Global Benefits Group Commercial |
$0.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.32
|
| Rate for Payer: Health Plan of Nevada - Sierra Transplant Other |
$0.27
|
| Rate for Payer: IEHP medi-cal |
$0.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: Multiplan Commercial |
$0.27
|
| Rate for Payer: Networks By Design Commercial |
$0.23
|
| Rate for Payer: Prime Health Services Commercial |
$0.31
|
| Rate for Payer: Redlands Yucaipa Medical Group Commercial/Senior |
$0.22
|
| Rate for Payer: Riverside University Health MISP |
$0.14
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.22
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.22
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.18
|
| Rate for Payer: United Healthcare All Other HMO |
$0.18
|
| Rate for Payer: United Healthcare HMO Rider |
$0.18
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.31
|
| Rate for Payer: Vantage Medical Group Senior |
$0.31
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [39275]
|
Facility
IP
|
$0.36
|
|
|
Service Code
|
NDC 51991-746-90
|
| Hospital Charge Code |
1711839
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.32 |
| Rate for Payer: Blue Shield of California Commercial |
$0.27
|
| Rate for Payer: Blue Shield of California EPN |
$0.19
|
| Rate for Payer: Cash Price |
$0.16
|
| Rate for Payer: Central Health Plan Commercial |
$0.29
|
| Rate for Payer: Cigna of CA HMO |
$0.25
|
| Rate for Payer: Cigna of CA PPO |
$0.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.14
|
| Rate for Payer: Galaxy Health WC |
$0.31
|
| Rate for Payer: Global Benefits Group Commercial |
$0.22
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.32
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: Multiplan Commercial |
$0.27
|
| Rate for Payer: Networks By Design Commercial |
$0.23
|
| Rate for Payer: Prime Health Services Commercial |
$0.31
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [39275]
|
Facility
IP
|
$0.59
|
|
|
Service Code
|
NDC 60505-2995-6
|
| Hospital Charge Code |
1711839
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.53 |
| Rate for Payer: Blue Shield of California Commercial |
$0.44
|
| Rate for Payer: Blue Shield of California EPN |
$0.32
|
| Rate for Payer: Cash Price |
$0.27
|
| Rate for Payer: Central Health Plan Commercial |
$0.47
|
| Rate for Payer: Cigna of CA HMO |
$0.41
|
| Rate for Payer: Cigna of CA PPO |
$0.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.50
|
| Rate for Payer: Global Benefits Group Commercial |
$0.35
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.53
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Multiplan Commercial |
$0.44
|
| Rate for Payer: Networks By Design Commercial |
$0.38
|
| Rate for Payer: Prime Health Services Commercial |
$0.50
|
|
|
DULOXETINE 20 MG CAPSULE,DELAYED RELEASE [39275]
|
Facility
IP
|
$2.12
|
|
|
Service Code
|
NDC 68084-675-11
|
| Hospital Charge Code |
1711839
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.42 |
| Max. Negotiated Rate |
$1.91 |
| Rate for Payer: Blue Shield of California Commercial |
$1.59
|
| Rate for Payer: Blue Shield of California EPN |
$1.13
|
| Rate for Payer: Cash Price |
$0.95
|
| Rate for Payer: Central Health Plan Commercial |
$1.70
|
| Rate for Payer: Cigna of CA HMO |
$1.48
|
| Rate for Payer: Cigna of CA PPO |
$1.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.85
|
| Rate for Payer: Galaxy Health WC |
$1.80
|
| Rate for Payer: Global Benefits Group Commercial |
$1.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.91
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.42
|
| Rate for Payer: Multiplan Commercial |
$1.59
|
| Rate for Payer: Networks By Design Commercial |
$1.38
|
| Rate for Payer: Prime Health Services Commercial |
$1.80
|
|
|
DULOXETINE 30 MG CAPSULE,DELAYED RELEASE [39276]
|
Facility
IP
|
$0.57
|
|
|
Service Code
|
NDC 68001-414-04
|
| Hospital Charge Code |
1711840
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.51 |
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.30
|
| Rate for Payer: Cash Price |
$0.26
|
| Rate for Payer: Central Health Plan Commercial |
$0.46
|
| Rate for Payer: Cigna of CA HMO |
$0.40
|
| Rate for Payer: Cigna of CA PPO |
$0.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.23
|
| Rate for Payer: Galaxy Health WC |
$0.48
|
| Rate for Payer: Global Benefits Group Commercial |
$0.34
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: Multiplan Commercial |
$0.43
|
| Rate for Payer: Networks By Design Commercial |
$0.37
|
| Rate for Payer: Prime Health Services Commercial |
$0.48
|
|
