|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 200 TOPICAL SPONGE [28026]
|
Facility
|
OP
|
$96.33
|
|
|
Service Code
|
NDC 0009-0349-03
|
| Hospital Charge Code |
ERX28026
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$19.27 |
| Max. Negotiated Rate |
$86.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58.50
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.88
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.98
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$52.98
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$56.91
|
| Rate for Payer: Blue Distinction Transplant |
$57.80
|
| Rate for Payer: Blue Shield of California Commercial |
$60.59
|
| Rate for Payer: Blue Shield of California EPN |
$47.11
|
| Rate for Payer: Cash Price |
$43.35
|
| Rate for Payer: Central Health Plan Commercial |
$77.06
|
| Rate for Payer: Cigna of CA HMO |
$61.65
|
| Rate for Payer: Cigna of CA PPO |
$71.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.88
|
| Rate for Payer: Dignity Health Media |
$81.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.53
|
| Rate for Payer: EPIC Health Plan Transplant |
$38.53
|
| Rate for Payer: Galaxy Health WC |
$81.88
|
| Rate for Payer: Global Benefits Group Commercial |
$57.80
|
| Rate for Payer: Health Management Network EPO/PPO |
$86.70
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$72.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$33.72
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$64.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$36.70
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.27
|
| Rate for Payer: Multiplan Commercial |
$72.25
|
| Rate for Payer: Networks By Design Commercial |
$62.61
|
| Rate for Payer: Prime Health Services Commercial |
$81.88
|
| Rate for Payer: Riverside University Health System MISP |
$38.53
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$48.16
|
| Rate for Payer: United Healthcare All Other HMO |
$48.16
|
| Rate for Payer: United Healthcare HMO Rider |
$48.16
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$48.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.88
|
| Rate for Payer: Vantage Medical Group Senior |
$81.88
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 4 TOPICAL SPONGE [28023]
|
Facility
|
IP
|
$16.16
|
|
|
Service Code
|
NDC 0009-0396-05
|
| Hospital Charge Code |
ERX28023
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$14.54 |
| Rate for Payer: Blue Shield of California Commercial |
$12.12
|
| Rate for Payer: Blue Shield of California EPN |
$8.63
|
| Rate for Payer: Cash Price |
$7.27
|
| Rate for Payer: Central Health Plan Commercial |
$12.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: Galaxy Health WC |
$13.74
|
| Rate for Payer: Global Benefits Group Commercial |
$9.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.54
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.23
|
| Rate for Payer: Multiplan Commercial |
$12.12
|
| Rate for Payer: Networks By Design Commercial |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$13.74
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 4 TOPICAL SPONGE [28023]
|
Facility
|
OP
|
$16.16
|
|
|
Service Code
|
NDC 0009-0396-05
|
| Hospital Charge Code |
ERX28023
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$3.23 |
| Max. Negotiated Rate |
$14.54 |
| Rate for Payer: Aetna of CA HMO/PPO |
$9.81
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$13.74
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.89
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.89
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.55
|
| Rate for Payer: Blue Distinction Transplant |
$9.70
|
| Rate for Payer: Blue Shield of California Commercial |
$10.16
|
| Rate for Payer: Blue Shield of California EPN |
$7.90
|
| Rate for Payer: Cash Price |
$7.27
|
| Rate for Payer: Central Health Plan Commercial |
$12.93
|
| Rate for Payer: Cigna of CA HMO |
$10.34
|
| Rate for Payer: Cigna of CA PPO |
$11.96
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$13.74
|
| Rate for Payer: Dignity Health Media |
$13.74
|
| Rate for Payer: Dignity Health Medi-Cal |
$13.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.46
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.46
|
| Rate for Payer: Galaxy Health WC |
$13.74
|
| Rate for Payer: Global Benefits Group Commercial |
$9.70
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.54
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$12.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$5.66
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.78
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.23
|
| Rate for Payer: Multiplan Commercial |
$12.12
|
| Rate for Payer: Networks By Design Commercial |
$10.50
|
| Rate for Payer: Prime Health Services Commercial |
$13.74
|
| Rate for Payer: Riverside University Health System MISP |
$6.46
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.70
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$8.08
|
| Rate for Payer: United Healthcare All Other HMO |
$8.08
|
| Rate for Payer: United Healthcare HMO Rider |
$8.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$13.74
|
| Rate for Payer: Vantage Medical Group Senior |
$13.74
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 50 TOPICAL SPONGE [28024]
|
Facility
|
IP
|
$33.61
|
|
|
Service Code
|
NDC 0009-0323-01
|
| Hospital Charge Code |
1743564
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$30.25 |
| Rate for Payer: Blue Shield of California Commercial |
$25.21
|
| Rate for Payer: Blue Shield of California EPN |
$17.95
|
| Rate for Payer: Cash Price |
$15.12
|
| Rate for Payer: Central Health Plan Commercial |
$26.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.44
|
| Rate for Payer: Galaxy Health WC |
$28.57
|
| Rate for Payer: Global Benefits Group Commercial |
$20.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.25
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.72
|
| Rate for Payer: Multiplan Commercial |
$25.21
|
| Rate for Payer: Networks By Design Commercial |
$21.85
|
| Rate for Payer: Prime Health Services Commercial |
$28.57
|
|
|
GELATIN SPONGE,ABSORBABLE-PORCINE SKIN 50 TOPICAL SPONGE [28024]
|
Facility
|
OP
|
$33.61
|
|
|
Service Code
|
NDC 0009-0323-01
|
| Hospital Charge Code |
1743564
|
|
Hospital Revenue Code
|
250
|
| Min. Negotiated Rate |
$6.72 |
| Max. Negotiated Rate |
$30.25 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$28.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$18.49
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$18.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$16.27
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.86
|
| Rate for Payer: Blue Distinction Transplant |
$20.17
|
| Rate for Payer: Blue Shield of California Commercial |
$21.14
|
| Rate for Payer: Blue Shield of California EPN |
$16.44
|
| Rate for Payer: Cash Price |
$15.12
|
| Rate for Payer: Central Health Plan Commercial |
$26.89
|
| Rate for Payer: Cigna of CA HMO |
$21.51
|
| Rate for Payer: Cigna of CA PPO |
$24.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$28.57
|
| Rate for Payer: Dignity Health Media |
$28.57
|
| Rate for Payer: Dignity Health Medi-Cal |
$28.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$13.44
|
| Rate for Payer: EPIC Health Plan Transplant |
$13.44
|
| Rate for Payer: Galaxy Health WC |
$28.57
|
| Rate for Payer: Global Benefits Group Commercial |
$20.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$30.25
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$25.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$11.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$22.42
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$12.81
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.72
|
| Rate for Payer: Multiplan Commercial |
$25.21
|
| Rate for Payer: Networks By Design Commercial |
$21.85
|
| Rate for Payer: Prime Health Services Commercial |
$28.57
|
| Rate for Payer: Riverside University Health System MISP |
$13.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$20.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$20.17
|
| Rate for Payer: United Healthcare All Other Commercial |
$16.80
|
| Rate for Payer: United Healthcare All Other HMO |
$16.80
|
| Rate for Payer: United Healthcare HMO Rider |
$16.80
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$16.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$28.57
|
| Rate for Payer: Vantage Medical Group Senior |
$28.57
|
|
|
GEMCITABINE 100 MG/ML INTRAVENOUS SOLUTION [220785]
|
Facility
|
OP
|
$15.84
|
|
|
Service Code
|
CPT J9196
|
| Hospital Charge Code |
NDG220785
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$54.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$7.67
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.36
|
| Rate for Payer: Blue Distinction Transplant |
$9.50
|
| Rate for Payer: Blue Shield of California Commercial |
$9.96
|
| Rate for Payer: Blue Shield of California EPN |
$7.75
|
| Rate for Payer: Caremore Medicare Advantage |
$11.51
|
| Rate for Payer: Cash Price |
$7.13
|
| Rate for Payer: Cash Price |
$7.13
|
| Rate for Payer: Central Health Plan Commercial |
$12.67
|
| Rate for Payer: Cigna of CA HMO |
$11.09
|
| Rate for Payer: Cigna of CA PPO |
$11.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.26
|
| Rate for Payer: Dignity Health Media |
$11.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.51
|
| Rate for Payer: Galaxy Health WC |
$13.46
|
| Rate for Payer: Global Benefits Group Commercial |
$9.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.26
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$11.88
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.51
|
| Rate for Payer: InnovAge PACE Commercial |
$17.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.42
|
| Rate for Payer: Multiplan Commercial |
$11.88
|
| Rate for Payer: Networks By Design Commercial |
$7.92
|
| Rate for Payer: Prime Health Services Commercial |
$13.46
|
| Rate for Payer: Prime Health Services Medicare |
$12.20
|
| Rate for Payer: Riverside University Health System MISP |
$12.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$9.50
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$9.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.92
|
| Rate for Payer: United Healthcare All Other HMO |
$7.92
|
| Rate for Payer: United Healthcare HMO Rider |
$7.92
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.92
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.66
|
| Rate for Payer: Vantage Medical Group Senior |
$11.51
|
|
|
GEMCITABINE 100 MG/ML INTRAVENOUS SOLUTION [220785]
|
Facility
|
OP
|
$6.65
|
|
|
Service Code
|
CPT J9196
|
| Hospital Charge Code |
NDG220785B
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$54.36 |
| Rate for Payer: Adventist Health Medi-Cal |
$11.51
|
| Rate for Payer: Aetna of CA HMO/PPO |
$54.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$14.39
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$12.66
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$12.66
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$3.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.93
|
| Rate for Payer: Blue Distinction Transplant |
$3.99
|
| Rate for Payer: Blue Shield of California Commercial |
$4.18
|
| Rate for Payer: Blue Shield of California EPN |
$3.25
|
| Rate for Payer: Caremore Medicare Advantage |
$11.51
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Central Health Plan Commercial |
$5.32
|
| Rate for Payer: Cigna of CA HMO |
$4.66
|
| Rate for Payer: Cigna of CA PPO |
$4.66
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$17.26
|
| Rate for Payer: Dignity Health Media |
$11.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.54
|
| Rate for Payer: EPIC Health Plan Medicare/Senior |
$11.51
|
| Rate for Payer: EPIC Health Plan Transplant |
$11.51
|
| Rate for Payer: Galaxy Health WC |
$5.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.98
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$4.99
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$18.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$18.99
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$11.51
|
| Rate for Payer: InnovAge PACE Commercial |
$17.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$25.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$11.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$15.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$15.42
|
| Rate for Payer: Multiplan Commercial |
$4.99
|
| Rate for Payer: Networks By Design Commercial |
$3.32
|
| Rate for Payer: Prime Health Services Commercial |
$5.65
|
| Rate for Payer: Prime Health Services Medicare |
$12.20
|
| Rate for Payer: Riverside University Health System MISP |
$12.66
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$3.99
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$3.99
|
| Rate for Payer: United Healthcare All Other Commercial |
$3.32
|
| Rate for Payer: United Healthcare All Other HMO |
$3.32
|
| Rate for Payer: United Healthcare HMO Rider |
$3.32
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$17.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.66
|
| Rate for Payer: Vantage Medical Group Senior |
$11.51
|
|
|
GEMCITABINE 100 MG/ML INTRAVENOUS SOLUTION [220785]
|
Facility
|
IP
|
$15.84
|
|
|
Service Code
|
CPT J9196
|
| Hospital Charge Code |
NDG220785
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.17 |
| Max. Negotiated Rate |
$14.26 |
| Rate for Payer: Blue Shield of California Commercial |
$11.88
|
| Rate for Payer: Blue Shield of California EPN |
$8.46
|
| Rate for Payer: Cash Price |
$7.13
|
| Rate for Payer: Central Health Plan Commercial |
$12.67
|
| Rate for Payer: Cigna of CA HMO |
$11.09
|
| Rate for Payer: Cigna of CA PPO |
$11.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.34
|
| Rate for Payer: EPIC Health Plan Transplant |
$6.34
|
| Rate for Payer: Galaxy Health WC |
$13.46
|
| Rate for Payer: Global Benefits Group Commercial |
$9.50
|
| Rate for Payer: Health Management Network EPO/PPO |
$14.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$10.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.17
|
| Rate for Payer: Multiplan Commercial |
$11.88
|
| Rate for Payer: Networks By Design Commercial |
$7.92
|
| Rate for Payer: Prime Health Services Commercial |
$13.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.98
|
| Rate for Payer: United Healthcare All Other HMO |
$5.84
|
| Rate for Payer: United Healthcare HMO Rider |
$5.72
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.23
|
|
|
GEMCITABINE 100 MG/ML INTRAVENOUS SOLUTION [220785]
|
Facility
|
IP
|
$6.65
|
|
|
Service Code
|
CPT J9196
|
| Hospital Charge Code |
NDG220785B
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.33 |
| Max. Negotiated Rate |
$5.98 |
| Rate for Payer: Blue Shield of California Commercial |
$4.99
|
| Rate for Payer: Blue Shield of California EPN |
$3.55
|
| Rate for Payer: Cash Price |
$2.99
|
| Rate for Payer: Central Health Plan Commercial |
$5.32
|
| Rate for Payer: Cigna of CA HMO |
$4.66
|
| Rate for Payer: Cigna of CA PPO |
$4.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.66
|
| Rate for Payer: EPIC Health Plan Transplant |
$2.66
|
| Rate for Payer: Galaxy Health WC |
$5.65
|
| Rate for Payer: Global Benefits Group Commercial |
$3.99
|
| Rate for Payer: Health Management Network EPO/PPO |
$5.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$4.44
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.33
|
| Rate for Payer: Multiplan Commercial |
$4.99
|
| Rate for Payer: Networks By Design Commercial |
$3.32
|
| Rate for Payer: Prime Health Services Commercial |
$5.65
|
| Rate for Payer: United Healthcare All Other Commercial |
$2.51
|
| Rate for Payer: United Healthcare All Other HMO |
$2.45
|
| Rate for Payer: United Healthcare HMO Rider |
$2.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$2.19
|
|
|
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION [191075]
|
Facility
|
OP
|
$2.07
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
NDG191075
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$230.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.76
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.14
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Blue Distinction Transplant |
$1.24
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Cash Price |
$0.93
|
| Rate for Payer: Cash Price |
$0.93
|
| Rate for Payer: Central Health Plan Commercial |
$1.66
|
| Rate for Payer: Cigna of CA HMO |
$1.45
|
| Rate for Payer: Cigna of CA PPO |
$1.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.76
|
| Rate for Payer: Dignity Health Media |
$1.76
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.83
|
| Rate for Payer: Galaxy Health WC |
$1.76
|
| Rate for Payer: Global Benefits Group Commercial |
$1.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.86
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1.55
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$1.55
|
| Rate for Payer: Networks By Design Commercial |
$1.04
|
| Rate for Payer: Prime Health Services Commercial |
$1.76
|
| Rate for Payer: Riverside University Health System MISP |
$0.83
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.24
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.04
|
| Rate for Payer: United Healthcare All Other HMO |
$1.04
|
| Rate for Payer: United Healthcare HMO Rider |
$1.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.04
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.76
|
| Rate for Payer: Vantage Medical Group Senior |
$1.76
|
|
|
GEMCITABINE 1 GRAM/26.3 ML (38 MG/ML) INTRAVENOUS SOLUTION [191075]
|
Facility
|
IP
|
$2.07
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
NDG191075
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.41 |
| Max. Negotiated Rate |
$1.86 |
| Rate for Payer: Blue Shield of California Commercial |
$1.55
|
| Rate for Payer: Blue Shield of California EPN |
$1.11
|
| Rate for Payer: Cash Price |
$0.93
|
| Rate for Payer: Central Health Plan Commercial |
$1.66
|
| Rate for Payer: Cigna of CA HMO |
$1.45
|
| Rate for Payer: Cigna of CA PPO |
$1.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.83
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.83
|
| Rate for Payer: Galaxy Health WC |
$1.76
|
| Rate for Payer: Global Benefits Group Commercial |
$1.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.86
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.38
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.79
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$1.55
|
| Rate for Payer: Networks By Design Commercial |
$1.04
|
| Rate for Payer: Prime Health Services Commercial |
$1.76
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.78
|
| Rate for Payer: United Healthcare All Other HMO |
$0.76
|
| Rate for Payer: United Healthcare HMO Rider |
$0.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.68
|
|
|
GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION [17122]
|
Facility
|
IP
|
$55.12
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
1755609
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.02 |
| Max. Negotiated Rate |
$49.61 |
| Rate for Payer: Blue Shield of California Commercial |
$41.34
|
| Rate for Payer: Blue Shield of California Commercial |
$42.30
|
| Rate for Payer: Blue Shield of California EPN |
$30.12
|
| Rate for Payer: Blue Shield of California EPN |
$29.43
|
| Rate for Payer: Cash Price |
$25.38
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Central Health Plan Commercial |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$45.12
|
| Rate for Payer: Cigna of CA HMO |
$38.58
|
| Rate for Payer: Cigna of CA HMO |
$39.48
|
| Rate for Payer: Cigna of CA PPO |
$39.48
|
| Rate for Payer: Cigna of CA PPO |
$38.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.05
|
| Rate for Payer: Galaxy Health WC |
$46.85
|
| Rate for Payer: Galaxy Health WC |
$47.94
|
| Rate for Payer: Global Benefits Group Commercial |
$33.07
|
| Rate for Payer: Global Benefits Group Commercial |
$33.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.61
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Multiplan Commercial |
$42.30
|
| Rate for Payer: Multiplan Commercial |
$41.34
|
| Rate for Payer: Networks By Design Commercial |
$28.20
|
| Rate for Payer: Networks By Design Commercial |
$27.56
|
| Rate for Payer: Prime Health Services Commercial |
$46.85
|
| Rate for Payer: Prime Health Services Commercial |
$47.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.30
|
| Rate for Payer: United Healthcare All Other HMO |
$20.80
|
| Rate for Payer: United Healthcare All Other HMO |
$20.33
|
| Rate for Payer: United Healthcare HMO Rider |
$19.89
|
| Rate for Payer: United Healthcare HMO Rider |
$20.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.19
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.61
|
|
|
GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION [17122]
|
Facility
|
OP
|
$55.12
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
1755609
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$230.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.02
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Blue Distinction Transplant |
$33.07
|
| Rate for Payer: Blue Distinction Transplant |
$33.84
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$25.38
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$25.38
|
| Rate for Payer: Central Health Plan Commercial |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$45.12
|
| Rate for Payer: Cigna of CA HMO |
$39.48
|
| Rate for Payer: Cigna of CA HMO |
$38.58
|
| Rate for Payer: Cigna of CA PPO |
$39.48
|
| Rate for Payer: Cigna of CA PPO |
$38.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.85
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.94
|
| Rate for Payer: Dignity Health Media |
$46.85
|
| Rate for Payer: Dignity Health Media |
$47.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.05
|
| Rate for Payer: Galaxy Health WC |
$46.85
|
| Rate for Payer: Galaxy Health WC |
$47.94
|
| Rate for Payer: Global Benefits Group Commercial |
$33.07
|
| Rate for Payer: Global Benefits Group Commercial |
$33.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.61
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$41.34
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$42.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.02
|
| Rate for Payer: Multiplan Commercial |
$41.34
|
| Rate for Payer: Multiplan Commercial |
$42.30
|
| Rate for Payer: Networks By Design Commercial |
$28.20
|
| Rate for Payer: Networks By Design Commercial |
$27.56
|
| Rate for Payer: Prime Health Services Commercial |
$47.94
|
| Rate for Payer: Prime Health Services Commercial |
$46.85
|
| Rate for Payer: Riverside University Health System MISP |
$22.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.07
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.56
|
| Rate for Payer: United Healthcare All Other HMO |
$28.20
|
| Rate for Payer: United Healthcare All Other HMO |
$27.56
|
| Rate for Payer: United Healthcare HMO Rider |
$27.56
|
| Rate for Payer: United Healthcare HMO Rider |
$28.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.94
|
| Rate for Payer: Vantage Medical Group Senior |
$46.85
|
| Rate for Payer: Vantage Medical Group Senior |
$47.94
|
|
|
GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION [400398]
|
Facility
|
IP
|
$56.40
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
ERX400398
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$11.28 |
| Max. Negotiated Rate |
$50.76 |
| Rate for Payer: Blue Shield of California Commercial |
$42.30
|
| Rate for Payer: Blue Shield of California Commercial |
$41.34
|
| Rate for Payer: Blue Shield of California EPN |
$30.12
|
| Rate for Payer: Blue Shield of California EPN |
$29.43
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$25.38
|
| Rate for Payer: Central Health Plan Commercial |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$45.12
|
| Rate for Payer: Cigna of CA HMO |
$38.58
|
| Rate for Payer: Cigna of CA HMO |
$39.48
|
| Rate for Payer: Cigna of CA PPO |
$38.58
|
| Rate for Payer: Cigna of CA PPO |
$39.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.56
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.56
|
| Rate for Payer: Galaxy Health WC |
$46.85
|
| Rate for Payer: Galaxy Health WC |
$47.94
|
| Rate for Payer: Global Benefits Group Commercial |
$33.84
|
| Rate for Payer: Global Benefits Group Commercial |
$33.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.62
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.77
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.00
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$21.49
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: Multiplan Commercial |
$42.30
|
| Rate for Payer: Multiplan Commercial |
$41.34
|
| Rate for Payer: Networks By Design Commercial |
$27.56
|
| Rate for Payer: Networks By Design Commercial |
$28.20
|
| Rate for Payer: Prime Health Services Commercial |
$47.94
|
| Rate for Payer: Prime Health Services Commercial |
$46.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$20.81
|
| Rate for Payer: United Healthcare All Other Commercial |
$21.30
|
| Rate for Payer: United Healthcare All Other HMO |
$20.33
|
| Rate for Payer: United Healthcare All Other HMO |
$20.80
|
| Rate for Payer: United Healthcare HMO Rider |
$19.89
|
| Rate for Payer: United Healthcare HMO Rider |
$20.35
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$18.19
|
|
|
GEMCITABINE 1 GRAM INTRAVENOUS SOLUTION [400398]
|
Facility
|
OP
|
$56.40
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
ERX400398
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$230.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$46.85
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$30.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$31.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$30.32
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Blue Distinction Transplant |
$33.07
|
| Rate for Payer: Blue Distinction Transplant |
$33.84
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$24.80
|
| Rate for Payer: Cash Price |
$25.38
|
| Rate for Payer: Cash Price |
$25.38
|
| Rate for Payer: Central Health Plan Commercial |
$44.10
|
| Rate for Payer: Central Health Plan Commercial |
$45.12
|
| Rate for Payer: Cigna of CA HMO |
$38.58
|
| Rate for Payer: Cigna of CA HMO |
$39.48
|
| Rate for Payer: Cigna of CA PPO |
$38.58
|
| Rate for Payer: Cigna of CA PPO |
$39.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$46.85
|
| Rate for Payer: Dignity Health Media |
$47.94
|
| Rate for Payer: Dignity Health Media |
$46.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$46.85
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.05
|
| Rate for Payer: EPIC Health Plan Transplant |
$22.56
|
| Rate for Payer: Galaxy Health WC |
$47.94
|
| Rate for Payer: Galaxy Health WC |
$46.85
|
| Rate for Payer: Global Benefits Group Commercial |
$33.07
|
| Rate for Payer: Global Benefits Group Commercial |
$33.84
|
| Rate for Payer: Health Management Network EPO/PPO |
$50.76
|
| Rate for Payer: Health Management Network EPO/PPO |
$49.61
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$42.30
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$41.34
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$36.77
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$37.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$11.02
|
| Rate for Payer: Multiplan Commercial |
$41.34
|
| Rate for Payer: Multiplan Commercial |
$42.30
|
| Rate for Payer: Networks By Design Commercial |
$28.20
|
| Rate for Payer: Networks By Design Commercial |
$27.56
|
| Rate for Payer: Prime Health Services Commercial |
$47.94
|
| Rate for Payer: Prime Health Services Commercial |
$46.85
|
| Rate for Payer: Riverside University Health System MISP |
$22.05
|
| Rate for Payer: Riverside University Health System MISP |
$22.56
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.84
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$33.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.84
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$33.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$27.56
|
| Rate for Payer: United Healthcare All Other Commercial |
$28.20
|
| Rate for Payer: United Healthcare All Other HMO |
$27.56
|
| Rate for Payer: United Healthcare All Other HMO |
$28.20
|
| Rate for Payer: United Healthcare HMO Rider |
$27.56
|
| Rate for Payer: United Healthcare HMO Rider |
$28.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$27.56
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$28.20
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$46.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.94
|
| Rate for Payer: Vantage Medical Group Senior |
$46.85
|
| Rate for Payer: Vantage Medical Group Senior |
$47.94
|
|
|
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION [191077]
|
Facility
|
IP
|
$1.76
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
NDG191077
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$1.58 |
| Rate for Payer: Blue Shield of California Commercial |
$1.32
|
| Rate for Payer: Blue Shield of California Commercial |
$0.86
|
| Rate for Payer: Blue Shield of California EPN |
$0.94
|
| Rate for Payer: Blue Shield of California EPN |
$0.61
|
| Rate for Payer: Cash Price |
$0.51
|
| Rate for Payer: Cash Price |
$0.79
|
| Rate for Payer: Central Health Plan Commercial |
$1.41
|
| Rate for Payer: Central Health Plan Commercial |
$0.91
|
| Rate for Payer: Cigna of CA HMO |
$0.80
|
| Rate for Payer: Cigna of CA HMO |
$1.23
|
| Rate for Payer: Cigna of CA PPO |
$0.80
|
| Rate for Payer: Cigna of CA PPO |
$1.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.46
|
| Rate for Payer: Galaxy Health WC |
$0.97
|
| Rate for Payer: Galaxy Health WC |
$1.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1.06
|
| Rate for Payer: Global Benefits Group Commercial |
$0.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.03
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.76
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.23
|
| Rate for Payer: Multiplan Commercial |
$1.32
|
| Rate for Payer: Multiplan Commercial |
$0.86
|
| Rate for Payer: Networks By Design Commercial |
$0.57
|
| Rate for Payer: Networks By Design Commercial |
$0.88
|
| Rate for Payer: Prime Health Services Commercial |
$1.50
|
| Rate for Payer: Prime Health Services Commercial |
$0.97
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.66
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.43
|
| Rate for Payer: United Healthcare All Other HMO |
$0.42
|
| Rate for Payer: United Healthcare All Other HMO |
$0.65
|
| Rate for Payer: United Healthcare HMO Rider |
$0.41
|
| Rate for Payer: United Healthcare HMO Rider |
$0.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.58
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.38
|
|
|
GEMCITABINE 200 MG/5.26 ML (38 MG/ML) INTRAVENOUS SOLUTION [191077]
|
Facility
|
OP
|
$1.76
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
NDG191077
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$230.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.97
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.63
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.63
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Blue Distinction Transplant |
$0.68
|
| Rate for Payer: Blue Distinction Transplant |
$1.06
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Cash Price |
$0.51
|
| Rate for Payer: Cash Price |
$0.79
|
| Rate for Payer: Cash Price |
$0.51
|
| Rate for Payer: Cash Price |
$0.79
|
| Rate for Payer: Central Health Plan Commercial |
$0.91
|
| Rate for Payer: Central Health Plan Commercial |
$1.41
|
| Rate for Payer: Cigna of CA HMO |
$1.23
|
| Rate for Payer: Cigna of CA HMO |
$0.80
|
| Rate for Payer: Cigna of CA PPO |
$0.80
|
| Rate for Payer: Cigna of CA PPO |
$1.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.97
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.50
|
| Rate for Payer: Dignity Health Media |
$0.97
|
| Rate for Payer: Dignity Health Media |
$1.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.46
|
| Rate for Payer: Galaxy Health WC |
$0.97
|
| Rate for Payer: Galaxy Health WC |
$1.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1.06
|
| Rate for Payer: Global Benefits Group Commercial |
$0.68
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.58
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.03
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.86
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.17
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: Multiplan Commercial |
$1.32
|
| Rate for Payer: Multiplan Commercial |
$0.86
|
| Rate for Payer: Networks By Design Commercial |
$0.88
|
| Rate for Payer: Networks By Design Commercial |
$0.57
|
| Rate for Payer: Prime Health Services Commercial |
$0.97
|
| Rate for Payer: Prime Health Services Commercial |
$1.50
|
| Rate for Payer: Riverside University Health System MISP |
$0.46
|
| Rate for Payer: Riverside University Health System MISP |
$0.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.88
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.57
|
| Rate for Payer: United Healthcare All Other HMO |
$0.57
|
| Rate for Payer: United Healthcare All Other HMO |
$0.88
|
| Rate for Payer: United Healthcare HMO Rider |
$0.88
|
| Rate for Payer: United Healthcare HMO Rider |
$0.57
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.57
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1.50
|
| Rate for Payer: Vantage Medical Group Senior |
$0.97
|
|
|
GEMCITABINE 200 MG INTRAVENOUS SOLUTION [17121]
|
Facility
|
OP
|
$18.00
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
1755759
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$230.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$9.38
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$12.29
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$10.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$9.90
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$7.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$6.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.70
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$6.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$9.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.92
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$7.95
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Blue Distinction Transplant |
$8.68
|
| Rate for Payer: Blue Distinction Transplant |
$8.64
|
| Rate for Payer: Blue Distinction Transplant |
$10.80
|
| Rate for Payer: Blue Distinction Transplant |
$7.31
|
| Rate for Payer: Blue Distinction Transplant |
$6.62
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$4.96
|
| Rate for Payer: Cash Price |
$4.96
|
| Rate for Payer: Cash Price |
$5.49
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Cash Price |
$5.49
|
| Rate for Payer: Cash Price |
$6.51
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$6.51
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Central Health Plan Commercial |
$11.57
|
| Rate for Payer: Central Health Plan Commercial |
$8.82
|
| Rate for Payer: Central Health Plan Commercial |
$9.75
|
| Rate for Payer: Central Health Plan Commercial |
$11.52
|
| Rate for Payer: Cigna of CA HMO |
$10.08
|
| Rate for Payer: Cigna of CA HMO |
$12.60
|
| Rate for Payer: Cigna of CA HMO |
$10.12
|
| Rate for Payer: Cigna of CA HMO |
$8.53
|
| Rate for Payer: Cigna of CA HMO |
$7.72
|
| Rate for Payer: Cigna of CA PPO |
$10.08
|
| Rate for Payer: Cigna of CA PPO |
$7.72
|
| Rate for Payer: Cigna of CA PPO |
$10.12
|
| Rate for Payer: Cigna of CA PPO |
$8.53
|
| Rate for Payer: Cigna of CA PPO |
$12.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$12.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.38
|
| Rate for Payer: Dignity Health Media |
$12.29
|
| Rate for Payer: Dignity Health Media |
$15.30
|
| Rate for Payer: Dignity Health Media |
$9.38
|
| Rate for Payer: Dignity Health Media |
$12.24
|
| Rate for Payer: Dignity Health Media |
$10.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$9.38
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$12.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.30
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.20
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.41
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Galaxy Health WC |
$12.29
|
| Rate for Payer: Galaxy Health WC |
$9.38
|
| Rate for Payer: Galaxy Health WC |
$12.24
|
| Rate for Payer: Galaxy Health WC |
$10.36
|
| Rate for Payer: Global Benefits Group Commercial |
$8.64
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Global Benefits Group Commercial |
$8.68
|
| Rate for Payer: Global Benefits Group Commercial |
$7.31
|
| Rate for Payer: Global Benefits Group Commercial |
$6.62
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.01
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10.84
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$8.27
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$10.80
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$13.50
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$9.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.60
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.21
|
| Rate for Payer: Multiplan Commercial |
$8.27
|
| Rate for Payer: Multiplan Commercial |
$9.14
|
| Rate for Payer: Multiplan Commercial |
$10.80
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Multiplan Commercial |
$10.84
|
| Rate for Payer: Networks By Design Commercial |
$5.52
|
| Rate for Payer: Networks By Design Commercial |
$9.00
|
| Rate for Payer: Networks By Design Commercial |
$7.20
|
| Rate for Payer: Networks By Design Commercial |
$7.23
|
| Rate for Payer: Networks By Design Commercial |
$6.10
|
| Rate for Payer: Prime Health Services Commercial |
$9.38
|
| Rate for Payer: Prime Health Services Commercial |
$12.29
|
| Rate for Payer: Prime Health Services Commercial |
$10.36
|
| Rate for Payer: Prime Health Services Commercial |
$12.24
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Riverside University Health System MISP |
$5.76
|
| Rate for Payer: Riverside University Health System MISP |
$5.78
|
| Rate for Payer: Riverside University Health System MISP |
$4.88
|
| Rate for Payer: Riverside University Health System MISP |
$7.20
|
| Rate for Payer: Riverside University Health System MISP |
$4.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.68
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$10.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$6.62
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$7.31
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$8.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$10.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.64
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$8.68
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$6.62
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$7.31
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$7.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.52
|
| Rate for Payer: United Healthcare All Other HMO |
$6.10
|
| Rate for Payer: United Healthcare All Other HMO |
$7.23
|
| Rate for Payer: United Healthcare All Other HMO |
$5.52
|
| Rate for Payer: United Healthcare All Other HMO |
$9.00
|
| Rate for Payer: United Healthcare All Other HMO |
$7.20
|
| Rate for Payer: United Healthcare HMO Rider |
$7.23
|
| Rate for Payer: United Healthcare HMO Rider |
$5.52
|
| Rate for Payer: United Healthcare HMO Rider |
$6.10
|
| Rate for Payer: United Healthcare HMO Rider |
$7.20
|
| Rate for Payer: United Healthcare HMO Rider |
$9.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.52
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$9.00
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$9.38
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$12.29
|
| Rate for Payer: Vantage Medical Group Senior |
$10.36
|
| Rate for Payer: Vantage Medical Group Senior |
$9.38
|
| Rate for Payer: Vantage Medical Group Senior |
$12.24
|
| Rate for Payer: Vantage Medical Group Senior |
$15.30
|
| Rate for Payer: Vantage Medical Group Senior |
$12.29
|
|
|
GEMCITABINE 200 MG INTRAVENOUS SOLUTION [17121]
|
Facility
|
IP
|
$18.00
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
1755759
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.60 |
| Max. Negotiated Rate |
$16.20 |
| Rate for Payer: Blue Shield of California Commercial |
$13.50
|
| Rate for Payer: Blue Shield of California Commercial |
$8.27
|
| Rate for Payer: Blue Shield of California Commercial |
$10.80
|
| Rate for Payer: Blue Shield of California Commercial |
$10.84
|
| Rate for Payer: Blue Shield of California Commercial |
$9.14
|
| Rate for Payer: Blue Shield of California EPN |
$9.61
|
| Rate for Payer: Blue Shield of California EPN |
$6.51
|
| Rate for Payer: Blue Shield of California EPN |
$7.72
|
| Rate for Payer: Blue Shield of California EPN |
$5.89
|
| Rate for Payer: Blue Shield of California EPN |
$7.69
|
| Rate for Payer: Cash Price |
$8.10
|
| Rate for Payer: Cash Price |
$6.51
|
| Rate for Payer: Cash Price |
$5.49
|
| Rate for Payer: Cash Price |
$4.96
|
| Rate for Payer: Cash Price |
$6.48
|
| Rate for Payer: Central Health Plan Commercial |
$11.52
|
| Rate for Payer: Central Health Plan Commercial |
$8.82
|
| Rate for Payer: Central Health Plan Commercial |
$14.40
|
| Rate for Payer: Central Health Plan Commercial |
$9.75
|
| Rate for Payer: Central Health Plan Commercial |
$11.57
|
| Rate for Payer: Cigna of CA HMO |
$7.72
|
| Rate for Payer: Cigna of CA HMO |
$12.60
|
| Rate for Payer: Cigna of CA HMO |
$10.08
|
| Rate for Payer: Cigna of CA HMO |
$8.53
|
| Rate for Payer: Cigna of CA HMO |
$10.12
|
| Rate for Payer: Cigna of CA PPO |
$7.72
|
| Rate for Payer: Cigna of CA PPO |
$10.12
|
| Rate for Payer: Cigna of CA PPO |
$8.53
|
| Rate for Payer: Cigna of CA PPO |
$10.08
|
| Rate for Payer: Cigna of CA PPO |
$12.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.78
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.41
|
| Rate for Payer: EPIC Health Plan Transplant |
$4.88
|
| Rate for Payer: EPIC Health Plan Transplant |
$5.76
|
| Rate for Payer: EPIC Health Plan Transplant |
$7.20
|
| Rate for Payer: Galaxy Health WC |
$12.29
|
| Rate for Payer: Galaxy Health WC |
$15.30
|
| Rate for Payer: Galaxy Health WC |
$12.24
|
| Rate for Payer: Galaxy Health WC |
$9.38
|
| Rate for Payer: Galaxy Health WC |
$10.36
|
| Rate for Payer: Global Benefits Group Commercial |
$8.68
|
| Rate for Payer: Global Benefits Group Commercial |
$8.64
|
| Rate for Payer: Global Benefits Group Commercial |
$6.62
|
| Rate for Payer: Global Benefits Group Commercial |
$10.80
|
| Rate for Payer: Global Benefits Group Commercial |
$7.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$13.01
|
| Rate for Payer: Health Management Network EPO/PPO |
$9.93
|
| Rate for Payer: Health Management Network EPO/PPO |
$10.97
|
| Rate for Payer: Health Management Network EPO/PPO |
$12.96
|
| Rate for Payer: Health Management Network EPO/PPO |
$16.20
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$7.36
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$8.13
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$9.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$12.01
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.64
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$6.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.20
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.51
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.21
|
| Rate for Payer: Multiplan Commercial |
$13.50
|
| Rate for Payer: Multiplan Commercial |
$9.14
|
| Rate for Payer: Multiplan Commercial |
$10.84
|
| Rate for Payer: Multiplan Commercial |
$8.27
|
| Rate for Payer: Multiplan Commercial |
$10.80
|
| Rate for Payer: Networks By Design Commercial |
$5.52
|
| Rate for Payer: Networks By Design Commercial |
$7.23
|
| Rate for Payer: Networks By Design Commercial |
$6.10
|
| Rate for Payer: Networks By Design Commercial |
$7.20
|
| Rate for Payer: Networks By Design Commercial |
$9.00
|
| Rate for Payer: Prime Health Services Commercial |
$12.29
|
| Rate for Payer: Prime Health Services Commercial |
$9.38
|
| Rate for Payer: Prime Health Services Commercial |
$15.30
|
| Rate for Payer: Prime Health Services Commercial |
$12.24
|
| Rate for Payer: Prime Health Services Commercial |
$10.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.44
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.60
|
| Rate for Payer: United Healthcare All Other Commercial |
$4.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$5.46
|
| Rate for Payer: United Healthcare All Other Commercial |
$6.80
|
| Rate for Payer: United Healthcare All Other HMO |
$5.33
|
| Rate for Payer: United Healthcare All Other HMO |
$4.50
|
| Rate for Payer: United Healthcare All Other HMO |
$4.07
|
| Rate for Payer: United Healthcare All Other HMO |
$5.31
|
| Rate for Payer: United Healthcare All Other HMO |
$6.64
|
| Rate for Payer: United Healthcare HMO Rider |
$3.98
|
| Rate for Payer: United Healthcare HMO Rider |
$5.20
|
| Rate for Payer: United Healthcare HMO Rider |
$4.40
|
| Rate for Payer: United Healthcare HMO Rider |
$6.49
|
| Rate for Payer: United Healthcare HMO Rider |
$5.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$5.94
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.75
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.77
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$3.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$4.02
|
|
|
GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION [191076]
|
Facility
|
OP
|
$1.76
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
NDG191076
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$230.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.97
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.97
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Blue Distinction Transplant |
$1.06
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Cash Price |
$0.79
|
| Rate for Payer: Cash Price |
$0.79
|
| Rate for Payer: Central Health Plan Commercial |
$1.41
|
| Rate for Payer: Cigna of CA HMO |
$1.23
|
| Rate for Payer: Cigna of CA PPO |
$1.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.50
|
| Rate for Payer: Dignity Health Media |
$1.50
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.70
|
| Rate for Payer: Galaxy Health WC |
$1.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.58
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$1.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: Multiplan Commercial |
$1.32
|
| Rate for Payer: Networks By Design Commercial |
$0.88
|
| Rate for Payer: Prime Health Services Commercial |
$1.50
|
| Rate for Payer: Riverside University Health System MISP |
$0.70
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.88
|
| Rate for Payer: United Healthcare All Other HMO |
$0.88
|
| Rate for Payer: United Healthcare HMO Rider |
$0.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.50
|
| Rate for Payer: Vantage Medical Group Senior |
$1.50
|
|
|
GEMCITABINE 2 GRAM/52.6 ML (38 MG/ML) INTRAVENOUS SOLUTION [191076]
|
Facility
|
IP
|
$1.76
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
NDG191076
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$1.58 |
| Rate for Payer: Blue Shield of California Commercial |
$1.32
|
| Rate for Payer: Blue Shield of California EPN |
$0.94
|
| Rate for Payer: Cash Price |
$0.79
|
| Rate for Payer: Central Health Plan Commercial |
$1.41
|
| Rate for Payer: Cigna of CA HMO |
$1.23
|
| Rate for Payer: Cigna of CA PPO |
$1.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.70
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.70
|
| Rate for Payer: Galaxy Health WC |
$1.50
|
| Rate for Payer: Global Benefits Group Commercial |
$1.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$1.17
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.67
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.35
|
| Rate for Payer: Multiplan Commercial |
$1.32
|
| Rate for Payer: Networks By Design Commercial |
$0.88
|
| Rate for Payer: Prime Health Services Commercial |
$1.50
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.66
|
| Rate for Payer: United Healthcare All Other HMO |
$0.65
|
| Rate for Payer: United Healthcare HMO Rider |
$0.64
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.58
|
|
|
GEMCITABINE 2 GRAM INTRAVENOUS SOLUTION [105417]
|
Facility
|
OP
|
$136.18
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
ERX105417
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.30 |
| Max. Negotiated Rate |
$230.05 |
| Rate for Payer: Aetna of CA HMO/PPO |
$7.20
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$115.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$74.90
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$74.90
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$210.11
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$230.05
|
| Rate for Payer: Blue Distinction Transplant |
$81.71
|
| Rate for Payer: Blue Shield of California Commercial |
$12.32
|
| Rate for Payer: Blue Shield of California EPN |
$11.20
|
| Rate for Payer: Cash Price |
$61.28
|
| Rate for Payer: Cash Price |
$61.28
|
| Rate for Payer: Central Health Plan Commercial |
$108.94
|
| Rate for Payer: Cigna of CA HMO |
$95.33
|
| Rate for Payer: Cigna of CA PPO |
$95.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$115.75
|
| Rate for Payer: Dignity Health Media |
$115.75
|
| Rate for Payer: Dignity Health Medi-Cal |
$115.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$54.47
|
| Rate for Payer: Galaxy Health WC |
$115.75
|
| Rate for Payer: Global Benefits Group Commercial |
$81.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.56
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$102.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$3.30
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$15.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.24
|
| Rate for Payer: Multiplan Commercial |
$102.14
|
| Rate for Payer: Networks By Design Commercial |
$68.09
|
| Rate for Payer: Prime Health Services Commercial |
$115.75
|
| Rate for Payer: Riverside University Health System MISP |
$54.47
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$81.71
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$81.71
|
| Rate for Payer: United Healthcare All Other Commercial |
$68.09
|
| Rate for Payer: United Healthcare All Other HMO |
$68.09
|
| Rate for Payer: United Healthcare HMO Rider |
$68.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$68.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$115.75
|
| Rate for Payer: Vantage Medical Group Senior |
$115.75
|
|
|
GEMCITABINE 2 GRAM INTRAVENOUS SOLUTION [105417]
|
Facility
|
IP
|
$136.18
|
|
|
Service Code
|
CPT J9201
|
| Hospital Charge Code |
ERX105417
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$27.24 |
| Max. Negotiated Rate |
$122.56 |
| Rate for Payer: Blue Shield of California Commercial |
$102.14
|
| Rate for Payer: Blue Shield of California EPN |
$72.72
|
| Rate for Payer: Cash Price |
$61.28
|
| Rate for Payer: Central Health Plan Commercial |
$108.94
|
| Rate for Payer: Cigna of CA HMO |
$95.33
|
| Rate for Payer: Cigna of CA PPO |
$95.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$54.47
|
| Rate for Payer: EPIC Health Plan Transplant |
$54.47
|
| Rate for Payer: Galaxy Health WC |
$115.75
|
| Rate for Payer: Global Benefits Group Commercial |
$81.71
|
| Rate for Payer: Health Management Network EPO/PPO |
$122.56
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$90.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$51.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$27.24
|
| Rate for Payer: Multiplan Commercial |
$102.14
|
| Rate for Payer: Networks By Design Commercial |
$68.09
|
| Rate for Payer: Prime Health Services Commercial |
$115.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$51.42
|
| Rate for Payer: United Healthcare All Other HMO |
$50.22
|
| Rate for Payer: United Healthcare HMO Rider |
$49.13
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$44.94
|
|
|
GEMFIBROZIL 600 MG TABLET [3378]
|
Facility
|
IP
|
$0.31
|
|
|
Service Code
|
NDC 60687-224-11
|
| Hospital Charge Code |
1711318
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.28 |
| Rate for Payer: Blue Shield of California Commercial |
$0.23
|
| Rate for Payer: Blue Shield of California EPN |
$0.17
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Central Health Plan Commercial |
$0.25
|
| Rate for Payer: Cigna of CA HMO |
$0.22
|
| Rate for Payer: Cigna of CA PPO |
$0.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.12
|
| Rate for Payer: Galaxy Health WC |
$0.26
|
| Rate for Payer: Global Benefits Group Commercial |
$0.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.28
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.23
|
| Rate for Payer: Networks By Design Commercial |
$0.20
|
| Rate for Payer: Prime Health Services Commercial |
$0.26
|
|
|
GEMFIBROZIL 600 MG TABLET [3378]
|
Facility
|
OP
|
$0.21
|
|
|
Service Code
|
NDC 65862-624-60
|
| Hospital Charge Code |
1711318
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.04 |
| Max. Negotiated Rate |
$0.19 |
| Rate for Payer: Aetna of CA HMO/PPO |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.12
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.12
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.12
|
| Rate for Payer: Blue Distinction Transplant |
$0.13
|
| Rate for Payer: Blue Shield of California Commercial |
$0.13
|
| Rate for Payer: Blue Shield of California EPN |
$0.10
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Central Health Plan Commercial |
$0.17
|
| Rate for Payer: Cigna of CA HMO |
$0.15
|
| Rate for Payer: Cigna of CA PPO |
$0.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.18
|
| Rate for Payer: Dignity Health Media |
$0.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: EPIC Health Plan Transplant |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.18
|
| Rate for Payer: Global Benefits Group Commercial |
$0.13
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.19
|
| Rate for Payer: Health Plan of Nevada (Sierra) Other |
$0.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial/Self Funded |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.16
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Prime Health Services Commercial |
$0.18
|
| Rate for Payer: Riverside University Health System MISP |
$0.08
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.13
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.18
|
| Rate for Payer: Vantage Medical Group Senior |
$0.18
|
|
