|
BUPIVACAINE-EPINEPHRINE (PF) 0.75 %-1:200,000 INJECTION SOLUTION [114890]
|
Facility
|
OP
|
$0.59
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.53 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.50
|
| Rate for Payer: Vantage Medical Group Senior |
$0.50
|
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.50
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.44
|
| Rate for Payer: Blue Shield of California Commercial |
$0.37
|
| Rate for Payer: Blue Shield of California EPN |
$0.24
|
| 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: Dignity Health Medi-Cal |
$0.50
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.41
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Senior |
$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 Foundation Hospitals Commercial/Self Funded |
$0.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.41
|
| Rate for Payer: Multiplan Commercial |
$0.44
|
| Rate for Payer: Networks By Design Commercial |
$0.30
|
| Rate for Payer: Prime Health Services Commercial |
$0.50
|
| Rate for Payer: Riverside University Health System 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 |
$0.22
|
| Rate for Payer: United Healthcare All Other HMO |
$0.22
|
| Rate for Payer: United Healthcare HMO Rider |
$0.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.19
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.50
|
|
|
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION [110560]
|
Facility
|
OP
|
$0.08
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.07 |
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.18
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.26
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.17
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.23
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California Commercial |
$0.06
|
| Rate for Payer: Blue Shield of California Commercial |
$0.05
|
| Rate for Payer: Blue Shield of California EPN |
$0.04
|
| Rate for Payer: Blue Shield of California EPN |
$0.03
|
| Rate for Payer: Blue Shield of California EPN |
$0.12
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Central Health Plan Commercial |
$0.07
|
| Rate for Payer: Central Health Plan Commercial |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.24
|
| Rate for Payer: Cigna of CA HMO |
$0.21
|
| Rate for Payer: Cigna of CA HMO |
$0.06
|
| Rate for Payer: Cigna of CA HMO |
$0.06
|
| Rate for Payer: Cigna of CA PPO |
$0.06
|
| Rate for Payer: Cigna of CA PPO |
$0.21
|
| Rate for Payer: Cigna of CA PPO |
$0.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.08
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.08
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: EPIC Health Plan Senior |
$0.03
|
| Rate for Payer: EPIC Health Plan Senior |
$0.04
|
| Rate for Payer: EPIC Health Plan Senior |
$0.12
|
| Rate for Payer: Galaxy Health WC |
$0.07
|
| Rate for Payer: Galaxy Health WC |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.26
|
| Rate for Payer: Global Benefits Group Commercial |
$0.05
|
| Rate for Payer: Global Benefits Group Commercial |
$0.05
|
| Rate for Payer: Global Benefits Group Commercial |
$0.18
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.23
|
| Rate for Payer: Multiplan Commercial |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.07
|
| Rate for Payer: Networks By Design Commercial |
$0.05
|
| Rate for Payer: Networks By Design Commercial |
$0.15
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Prime Health Services Commercial |
$0.08
|
| Rate for Payer: Prime Health Services Commercial |
$0.26
|
| Rate for Payer: Prime Health Services Commercial |
$0.07
|
| Rate for Payer: Riverside University Health System MISP |
$0.03
|
| Rate for Payer: Riverside University Health System MISP |
$0.04
|
| Rate for Payer: Riverside University Health System MISP |
$0.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.08
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.26
|
| Rate for Payer: Vantage Medical Group Senior |
$0.08
|
| Rate for Payer: Vantage Medical Group Senior |
$0.26
|
| Rate for Payer: Vantage Medical Group Senior |
$0.07
|
|
|
BUPIVACAINE HCL 0.25 % (2.5 MG/ML) INJECTION SOLUTION [110560]
|
Facility
|
IP
|
$0.30
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.06 |
| Max. Negotiated Rate |
$0.27 |
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Blue Shield of California Commercial |
$0.24
|
| Rate for Payer: Blue Shield of California Commercial |
$0.07
|
| Rate for Payer: Blue Shield of California Commercial |
$0.06
|
| Rate for Payer: Blue Shield of California EPN |
$0.04
|
| Rate for Payer: Blue Shield of California EPN |
$0.15
|
| Rate for Payer: Blue Shield of California EPN |
$0.05
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Central Health Plan Commercial |
$0.07
|
| Rate for Payer: Central Health Plan Commercial |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.24
|
| Rate for Payer: Cigna of CA HMO |
$0.21
|
| Rate for Payer: Cigna of CA HMO |
$0.06
|
| Rate for Payer: Cigna of CA HMO |
$0.06
|
| Rate for Payer: Cigna of CA PPO |
$0.21
|
| Rate for Payer: Cigna of CA PPO |
$0.06
|
| Rate for Payer: Cigna of CA PPO |
$0.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.12
|
| Rate for Payer: EPIC Health Plan Senior |
$0.04
|
| Rate for Payer: EPIC Health Plan Senior |
$0.03
|
| Rate for Payer: EPIC Health Plan Senior |
$0.12
|
| Rate for Payer: Galaxy Health WC |
$0.08
|
| Rate for Payer: Galaxy Health WC |
$0.07
|
| Rate for Payer: Galaxy Health WC |
$0.26
|
| Rate for Payer: Global Benefits Group Commercial |
$0.18
|
| Rate for Payer: Global Benefits Group Commercial |
$0.05
|
| Rate for Payer: Global Benefits Group Commercial |
$0.05
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Multiplan Commercial |
$0.23
|
| Rate for Payer: Multiplan Commercial |
$0.07
|
| Rate for Payer: Multiplan Commercial |
$0.06
|
| Rate for Payer: Networks By Design Commercial |
$0.15
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Networks By Design Commercial |
$0.05
|
| Rate for Payer: Prime Health Services Commercial |
$0.08
|
| Rate for Payer: Prime Health Services Commercial |
$0.26
|
| Rate for Payer: Prime Health Services Commercial |
$0.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
|
|
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION [1223]
|
Facility
|
OP
|
$0.08
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$8.49 |
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.07
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.29
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.26
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.06
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Central Health Plan Commercial |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.27
|
| Rate for Payer: Cigna of CA HMO |
$0.05
|
| Rate for Payer: Cigna of CA HMO |
$0.24
|
| Rate for Payer: Cigna of CA HMO |
$0.06
|
| Rate for Payer: Cigna of CA PPO |
$0.05
|
| Rate for Payer: Cigna of CA PPO |
$0.06
|
| Rate for Payer: Cigna of CA PPO |
$0.24
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.29
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.07
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.29
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.14
|
| Rate for Payer: EPIC Health Plan Senior |
$0.14
|
| Rate for Payer: EPIC Health Plan Senior |
$0.03
|
| Rate for Payer: EPIC Health Plan Senior |
$0.03
|
| Rate for Payer: Galaxy Health WC |
$0.29
|
| Rate for Payer: Galaxy Health WC |
$0.07
|
| Rate for Payer: Galaxy Health WC |
$0.06
|
| Rate for Payer: Global Benefits Group Commercial |
$0.20
|
| Rate for Payer: Global Benefits Group Commercial |
$0.05
|
| Rate for Payer: Global Benefits Group Commercial |
$0.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.05
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.26
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Prime Health Services Commercial |
$0.29
|
| Rate for Payer: Prime Health Services Commercial |
$0.07
|
| Rate for Payer: Prime Health Services Commercial |
$0.06
|
| Rate for Payer: Riverside University Health System MISP |
$0.03
|
| Rate for Payer: Riverside University Health System MISP |
$0.14
|
| Rate for Payer: Riverside University Health System MISP |
$0.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.05
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.04
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.05
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.12
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.29
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.06
|
| Rate for Payer: Vantage Medical Group Senior |
$0.29
|
| Rate for Payer: Vantage Medical Group Senior |
$0.06
|
| Rate for Payer: Vantage Medical Group Senior |
$0.07
|
|
|
BUPIVACAINE HCL 0.5 % (5 MG/ML) INJECTION SOLUTION [1223]
|
Facility
|
IP
|
$0.34
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.31 |
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.27
|
| Rate for Payer: Blue Shield of California Commercial |
$0.06
|
| Rate for Payer: Blue Shield of California Commercial |
$0.06
|
| Rate for Payer: Blue Shield of California EPN |
$0.04
|
| Rate for Payer: Blue Shield of California EPN |
$0.17
|
| Rate for Payer: Blue Shield of California EPN |
$0.04
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Central Health Plan Commercial |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.27
|
| Rate for Payer: Cigna of CA HMO |
$0.24
|
| Rate for Payer: Cigna of CA HMO |
$0.05
|
| Rate for Payer: Cigna of CA HMO |
$0.06
|
| Rate for Payer: Cigna of CA PPO |
$0.24
|
| Rate for Payer: Cigna of CA PPO |
$0.06
|
| Rate for Payer: Cigna of CA PPO |
$0.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.06
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.14
|
| Rate for Payer: EPIC Health Plan Senior |
$0.03
|
| Rate for Payer: EPIC Health Plan Senior |
$0.03
|
| Rate for Payer: EPIC Health Plan Senior |
$0.14
|
| Rate for Payer: Galaxy Health WC |
$0.07
|
| Rate for Payer: Galaxy Health WC |
$0.06
|
| Rate for Payer: Galaxy Health WC |
$0.29
|
| Rate for Payer: Global Benefits Group Commercial |
$0.20
|
| Rate for Payer: Global Benefits Group Commercial |
$0.05
|
| Rate for Payer: Global Benefits Group Commercial |
$0.04
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.31
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.20
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.05
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.26
|
| Rate for Payer: Multiplan Commercial |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Prime Health Services Commercial |
$0.07
|
| Rate for Payer: Prime Health Services Commercial |
$0.29
|
| Rate for Payer: Prime Health Services Commercial |
$0.06
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
|
|
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION [153079]
|
Facility
|
OP
|
$25.12
|
|
|
Service Code
|
HCPCS J0666
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.45 |
| Max. Negotiated Rate |
$22.61 |
| Rate for Payer: Adventist Health Commercial |
$5.02
|
| Rate for Payer: Adventist Health Medi-Cal |
$1.83
|
| Rate for Payer: Aetna of CA HMO/PPO |
$8.84
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.83
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$2.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$3.52
|
| Rate for Payer: Blue Shield of California Commercial |
$1.87
|
| Rate for Payer: Blue Shield of California EPN |
$1.70
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Central Health Plan Commercial |
$20.10
|
| Rate for Payer: Cigna of CA HMO |
$17.58
|
| Rate for Payer: Cigna of CA PPO |
$17.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.01
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.02
|
| Rate for Payer: EPIC Health Plan Senior |
$2.01
|
| Rate for Payer: Galaxy Health WC |
$21.35
|
| Rate for Payer: Global Benefits Group Commercial |
$15.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.61
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$3.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1.83
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$2.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.45
|
| Rate for Payer: Multiplan Commercial |
$18.84
|
| Rate for Payer: Networks By Design Commercial |
$12.56
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1.83
|
| Rate for Payer: Prime Health Services Commercial |
$21.35
|
| Rate for Payer: Prime Health Services Medicare |
$1.94
|
| Rate for Payer: Riverside University Health System MISP |
$2.01
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$15.07
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$15.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.43
|
| Rate for Payer: United Healthcare All Other HMO |
$9.18
|
| Rate for Payer: United Healthcare HMO Rider |
$8.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.23
|
| Rate for Payer: Upland Medical Group Pediatric |
$1.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.29
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.01
|
| Rate for Payer: Vantage Medical Group Senior |
$2.01
|
|
|
BUPIVACAINE LIPOSOME(PF) 1.3 %(13.3 MG/ML) SUSPENSION FOR INFILTRATION [153079]
|
Facility
|
IP
|
$25.12
|
|
|
Service Code
|
HCPCS J0666
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.02 |
| Max. Negotiated Rate |
$22.61 |
| Rate for Payer: Adventist Health Commercial |
$5.02
|
| Rate for Payer: Blue Shield of California Commercial |
$20.15
|
| Rate for Payer: Blue Shield of California EPN |
$12.66
|
| Rate for Payer: Cash Price |
$11.30
|
| Rate for Payer: Central Health Plan Commercial |
$20.10
|
| Rate for Payer: Cigna of CA HMO |
$17.58
|
| Rate for Payer: Cigna of CA PPO |
$17.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$17.58
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.05
|
| Rate for Payer: EPIC Health Plan Senior |
$10.05
|
| Rate for Payer: Galaxy Health WC |
$21.35
|
| Rate for Payer: Global Benefits Group Commercial |
$15.07
|
| Rate for Payer: Health Management Network EPO/PPO |
$22.61
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$15.95
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$14.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.02
|
| Rate for Payer: Multiplan Commercial |
$18.84
|
| Rate for Payer: Networks By Design Commercial |
$12.56
|
| Rate for Payer: Prime Health Services Commercial |
$21.35
|
| Rate for Payer: United Healthcare All Other Commercial |
$9.43
|
| Rate for Payer: United Healthcare All Other HMO |
$9.18
|
| Rate for Payer: United Healthcare HMO Rider |
$8.98
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.23
|
|
|
BUPIVACAINE-MELOXICAM ER 200 MG-6 MG/7 ML SURGICAL SITE INSTILL SOLN [231886]
|
Facility
|
IP
|
$26.90
|
|
|
Service Code
|
HCPCS J0668
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.38 |
| Max. Negotiated Rate |
$24.21 |
| Rate for Payer: Adventist Health Commercial |
$5.38
|
| Rate for Payer: Blue Shield of California Commercial |
$21.57
|
| Rate for Payer: Blue Shield of California EPN |
$13.56
|
| Rate for Payer: Cash Price |
$12.10
|
| Rate for Payer: Central Health Plan Commercial |
$21.52
|
| Rate for Payer: Cigna of CA HMO |
$18.83
|
| Rate for Payer: Cigna of CA PPO |
$18.83
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.76
|
| Rate for Payer: EPIC Health Plan Senior |
$10.76
|
| Rate for Payer: Galaxy Health WC |
$22.86
|
| Rate for Payer: Global Benefits Group Commercial |
$16.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$15.87
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.38
|
| Rate for Payer: Multiplan Commercial |
$20.18
|
| Rate for Payer: Networks By Design Commercial |
$13.45
|
| Rate for Payer: Prime Health Services Commercial |
$22.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$9.83
|
| Rate for Payer: United Healthcare HMO Rider |
$9.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.81
|
|
|
BUPIVACAINE-MELOXICAM ER 200 MG-6 MG/7 ML SURGICAL SITE INSTILL SOLN [231886]
|
Facility
|
OP
|
$26.90
|
|
|
Service Code
|
HCPCS J0668
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.07 |
| Max. Negotiated Rate |
$24.21 |
| Rate for Payer: Adventist Health Commercial |
$5.38
|
| Rate for Payer: Adventist Health Medi-Cal |
$1.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$16.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.07
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$1.54
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1.92
|
| Rate for Payer: Blue Shield of California Commercial |
$17.05
|
| Rate for Payer: Blue Shield of California EPN |
$10.73
|
| Rate for Payer: Cash Price |
$12.10
|
| Rate for Payer: Cash Price |
$12.10
|
| Rate for Payer: Central Health Plan Commercial |
$21.52
|
| Rate for Payer: Cigna of CA HMO |
$18.83
|
| Rate for Payer: Cigna of CA PPO |
$18.83
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$18.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.77
|
| Rate for Payer: EPIC Health Plan Senior |
$1.18
|
| Rate for Payer: Galaxy Health WC |
$22.86
|
| Rate for Payer: Global Benefits Group Commercial |
$16.14
|
| Rate for Payer: Health Management Network EPO/PPO |
$24.21
|
| Rate for Payer: Heritage Provider Network Commercial/Senior |
$1.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$1.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$1.07
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$17.08
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1.50
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.38
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.43
|
| Rate for Payer: Multiplan Commercial |
$20.18
|
| Rate for Payer: Networks By Design Commercial |
$13.45
|
| Rate for Payer: OptumHealth Care Solutions (URN) Medicare Advantage |
$1.07
|
| Rate for Payer: Prime Health Services Commercial |
$22.86
|
| Rate for Payer: Prime Health Services Medicare |
$1.13
|
| Rate for Payer: Riverside University Health System MISP |
$1.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$16.14
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$16.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$10.10
|
| Rate for Payer: United Healthcare All Other HMO |
$9.83
|
| Rate for Payer: United Healthcare HMO Rider |
$9.61
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$8.81
|
| Rate for Payer: Upland Medical Group Pediatric |
$1.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.18
|
| Rate for Payer: Vantage Medical Group Senior |
$1.07
|
|
|
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION [1222]
|
Facility
|
IP
|
$0.27
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.05 |
| Max. Negotiated Rate |
$0.24 |
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Blue Shield of California Commercial |
$0.08
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.06
|
| Rate for Payer: Blue Shield of California Commercial |
$0.20
|
| Rate for Payer: Blue Shield of California EPN |
$0.14
|
| Rate for Payer: Blue Shield of California EPN |
$0.05
|
| Rate for Payer: Blue Shield of California EPN |
$0.14
|
| Rate for Payer: Blue Shield of California EPN |
$0.13
|
| Rate for Payer: Blue Shield of California EPN |
$0.04
|
| Rate for Payer: Cash Price |
$0.11
|
| Rate for Payer: Cash Price |
$0.05
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Central Health Plan Commercial |
$0.22
|
| Rate for Payer: Central Health Plan Commercial |
$0.08
|
| Rate for Payer: Central Health Plan Commercial |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.20
|
| Rate for Payer: Central Health Plan Commercial |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.20
|
| Rate for Payer: Cigna of CA HMO |
$0.18
|
| Rate for Payer: Cigna of CA HMO |
$0.05
|
| Rate for Payer: Cigna of CA HMO |
$0.07
|
| Rate for Payer: Cigna of CA HMO |
$0.19
|
| Rate for Payer: Cigna of CA PPO |
$0.07
|
| Rate for Payer: Cigna of CA PPO |
$0.05
|
| Rate for Payer: Cigna of CA PPO |
$0.20
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: Cigna of CA PPO |
$0.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.18
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Senior |
$0.10
|
| Rate for Payer: EPIC Health Plan Senior |
$0.03
|
| Rate for Payer: EPIC Health Plan Senior |
$0.04
|
| Rate for Payer: EPIC Health Plan Senior |
$0.11
|
| Rate for Payer: EPIC Health Plan Senior |
$0.11
|
| Rate for Payer: Galaxy Health WC |
$0.23
|
| Rate for Payer: Galaxy Health WC |
$0.06
|
| Rate for Payer: Galaxy Health WC |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.21
|
| Rate for Payer: Galaxy Health WC |
$0.09
|
| Rate for Payer: Global Benefits Group Commercial |
$0.17
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Global Benefits Group Commercial |
$0.04
|
| Rate for Payer: Global Benefits Group Commercial |
$0.15
|
| Rate for Payer: Global Benefits Group Commercial |
$0.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.06
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.24
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.17
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.21
|
| Rate for Payer: Multiplan Commercial |
$0.19
|
| Rate for Payer: Multiplan Commercial |
$0.08
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Networks By Design Commercial |
$0.05
|
| Rate for Payer: Networks By Design Commercial |
$0.13
|
| Rate for Payer: Prime Health Services Commercial |
$0.24
|
| Rate for Payer: Prime Health Services Commercial |
$0.09
|
| Rate for Payer: Prime Health Services Commercial |
$0.21
|
| Rate for Payer: Prime Health Services Commercial |
$0.06
|
| Rate for Payer: Prime Health Services Commercial |
$0.23
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.10
|
| Rate for Payer: United Healthcare All Other HMO |
$0.09
|
| Rate for Payer: United Healthcare All Other HMO |
$0.04
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.10
|
| Rate for Payer: United Healthcare All Other HMO |
$0.10
|
| Rate for Payer: United Healthcare HMO Rider |
$0.10
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.09
|
| Rate for Payer: United Healthcare HMO Rider |
$0.04
|
| Rate for Payer: United Healthcare HMO Rider |
$0.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.08
|
|
|
BUPIVACAINE (PF) 0.25 % (2.5 MG/ML) INJECTION SOLUTION [1222]
|
Facility
|
OP
|
$0.27
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$8.49 |
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Adventist Health Commercial |
$0.05
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.09
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.21
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.04
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.21
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.05
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.20
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cash Price |
$0.11
|
| Rate for Payer: Cash Price |
$0.05
|
| Rate for Payer: Cash Price |
$0.05
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cash Price |
$0.13
|
| Rate for Payer: Cash Price |
$0.12
|
| Rate for Payer: Cash Price |
$0.11
|
| Rate for Payer: Central Health Plan Commercial |
$0.20
|
| Rate for Payer: Central Health Plan Commercial |
$0.08
|
| Rate for Payer: Central Health Plan Commercial |
$0.22
|
| Rate for Payer: Central Health Plan Commercial |
$0.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.20
|
| Rate for Payer: Cigna of CA HMO |
$0.18
|
| Rate for Payer: Cigna of CA HMO |
$0.05
|
| Rate for Payer: Cigna of CA HMO |
$0.07
|
| Rate for Payer: Cigna of CA HMO |
$0.19
|
| Rate for Payer: Cigna of CA PPO |
$0.20
|
| Rate for Payer: Cigna of CA PPO |
$0.19
|
| Rate for Payer: Cigna of CA PPO |
$0.05
|
| Rate for Payer: Cigna of CA PPO |
$0.07
|
| Rate for Payer: Cigna of CA PPO |
$0.18
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.21
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.23
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.23
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.06
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.21
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.23
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.24
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.19
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.05
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.20
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.07
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: EPIC Health Plan Senior |
$0.10
|
| Rate for Payer: EPIC Health Plan Senior |
$0.03
|
| Rate for Payer: EPIC Health Plan Senior |
$0.04
|
| Rate for Payer: EPIC Health Plan Senior |
$0.11
|
| Rate for Payer: EPIC Health Plan Senior |
$0.11
|
| Rate for Payer: Galaxy Health WC |
$0.23
|
| Rate for Payer: Galaxy Health WC |
$0.21
|
| Rate for Payer: Galaxy Health WC |
$0.24
|
| Rate for Payer: Galaxy Health WC |
$0.09
|
| Rate for Payer: Galaxy Health WC |
$0.06
|
| Rate for Payer: Global Benefits Group Commercial |
$0.04
|
| Rate for Payer: Global Benefits Group Commercial |
$0.17
|
| Rate for Payer: Global Benefits Group Commercial |
$0.15
|
| Rate for Payer: Global Benefits Group Commercial |
$0.06
|
| Rate for Payer: Global Benefits Group Commercial |
$0.16
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.25
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.24
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.09
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.23
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.17
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.18
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.04
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.16
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.04
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.15
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.05
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.19
|
| Rate for Payer: Multiplan Commercial |
$0.20
|
| Rate for Payer: Multiplan Commercial |
$0.08
|
| Rate for Payer: Multiplan Commercial |
$0.21
|
| Rate for Payer: Multiplan Commercial |
$0.19
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: Networks By Design Commercial |
$0.13
|
| Rate for Payer: Networks By Design Commercial |
$0.05
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Networks By Design Commercial |
$0.14
|
| Rate for Payer: Networks By Design Commercial |
$0.04
|
| Rate for Payer: Prime Health Services Commercial |
$0.06
|
| Rate for Payer: Prime Health Services Commercial |
$0.24
|
| Rate for Payer: Prime Health Services Commercial |
$0.23
|
| Rate for Payer: Prime Health Services Commercial |
$0.21
|
| Rate for Payer: Prime Health Services Commercial |
$0.09
|
| Rate for Payer: Riverside University Health System MISP |
$0.10
|
| Rate for Payer: Riverside University Health System MISP |
$0.11
|
| Rate for Payer: Riverside University Health System MISP |
$0.11
|
| Rate for Payer: Riverside University Health System MISP |
$0.04
|
| Rate for Payer: Riverside University Health System MISP |
$0.03
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.15
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.16
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.04
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.06
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.06
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.15
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.17
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.16
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.03
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.04
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.10
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.10
|
| Rate for Payer: United Healthcare All Other HMO |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO |
$0.04
|
| Rate for Payer: United Healthcare All Other HMO |
$0.09
|
| Rate for Payer: United Healthcare All Other HMO |
$0.10
|
| Rate for Payer: United Healthcare HMO Rider |
$0.10
|
| Rate for Payer: United Healthcare HMO Rider |
$0.10
|
| Rate for Payer: United Healthcare HMO Rider |
$0.03
|
| Rate for Payer: United Healthcare HMO Rider |
$0.09
|
| Rate for Payer: United Healthcare HMO Rider |
$0.04
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.02
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.08
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.24
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.06
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.21
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.23
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.21
|
| Rate for Payer: Vantage Medical Group Senior |
$0.09
|
| Rate for Payer: Vantage Medical Group Senior |
$0.24
|
| Rate for Payer: Vantage Medical Group Senior |
$0.06
|
| Rate for Payer: Vantage Medical Group Senior |
$0.21
|
| Rate for Payer: Vantage Medical Group Senior |
$0.23
|
|
|
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION [105640]
|
Facility
|
OP
|
$0.62
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$8.49 |
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Adventist Health Commercial |
$0.14
|
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.53
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.34
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.51
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.47
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: Cash Price |
$0.31
|
| Rate for Payer: Cash Price |
$0.31
|
| Rate for Payer: Central Health Plan Commercial |
$0.26
|
| Rate for Payer: Central Health Plan Commercial |
$0.50
|
| Rate for Payer: Central Health Plan Commercial |
$0.54
|
| Rate for Payer: Cigna of CA HMO |
$0.23
|
| Rate for Payer: Cigna of CA HMO |
$0.48
|
| Rate for Payer: Cigna of CA HMO |
$0.43
|
| Rate for Payer: Cigna of CA PPO |
$0.23
|
| Rate for Payer: Cigna of CA PPO |
$0.43
|
| Rate for Payer: Cigna of CA PPO |
$0.48
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.53
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.27
|
| Rate for Payer: EPIC Health Plan Senior |
$0.27
|
| Rate for Payer: EPIC Health Plan Senior |
$0.25
|
| Rate for Payer: EPIC Health Plan Senior |
$0.13
|
| Rate for Payer: Galaxy Health WC |
$0.58
|
| Rate for Payer: Galaxy Health WC |
$0.53
|
| Rate for Payer: Galaxy Health WC |
$0.28
|
| Rate for Payer: Global Benefits Group Commercial |
$0.41
|
| Rate for Payer: Global Benefits Group Commercial |
$0.37
|
| Rate for Payer: Global Benefits Group Commercial |
$0.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.39
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.37
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.43
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.48
|
| Rate for Payer: Multiplan Commercial |
$0.25
|
| Rate for Payer: Multiplan Commercial |
$0.47
|
| Rate for Payer: Multiplan Commercial |
$0.51
|
| Rate for Payer: Networks By Design Commercial |
$0.31
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.34
|
| Rate for Payer: Prime Health Services Commercial |
$0.58
|
| Rate for Payer: Prime Health Services Commercial |
$0.53
|
| Rate for Payer: Prime Health Services Commercial |
$0.28
|
| Rate for Payer: Riverside University Health System MISP |
$0.25
|
| Rate for Payer: Riverside University Health System MISP |
$0.27
|
| Rate for Payer: Riverside University Health System MISP |
$0.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.37
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.41
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.37
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.41
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.23
|
| Rate for Payer: United Healthcare All Other HMO |
$0.25
|
| Rate for Payer: United Healthcare All Other HMO |
$0.23
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare HMO Rider |
$0.22
|
| Rate for Payer: United Healthcare HMO Rider |
$0.24
|
| Rate for Payer: United Healthcare HMO Rider |
$0.12
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.20
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.58
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.53
|
|
|
BUPIVACAINE (PF) 0.5 % (5 MG/ML) INJECTION SOLUTION [105640]
|
Facility
|
IP
|
$0.68
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$0.61 |
| Rate for Payer: Adventist Health Commercial |
$0.14
|
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Blue Shield of California Commercial |
$0.55
|
| Rate for Payer: Blue Shield of California Commercial |
$0.50
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California EPN |
$0.17
|
| Rate for Payer: Blue Shield of California EPN |
$0.34
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Cash Price |
$0.31
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: Central Health Plan Commercial |
$0.50
|
| Rate for Payer: Central Health Plan Commercial |
$0.26
|
| Rate for Payer: Central Health Plan Commercial |
$0.54
|
| Rate for Payer: Cigna of CA HMO |
$0.48
|
| Rate for Payer: Cigna of CA HMO |
$0.23
|
| Rate for Payer: Cigna of CA HMO |
$0.43
|
| Rate for Payer: Cigna of CA PPO |
$0.48
|
| Rate for Payer: Cigna of CA PPO |
$0.43
|
| Rate for Payer: Cigna of CA PPO |
$0.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.48
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.43
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.23
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.27
|
| Rate for Payer: EPIC Health Plan Senior |
$0.25
|
| Rate for Payer: EPIC Health Plan Senior |
$0.13
|
| Rate for Payer: EPIC Health Plan Senior |
$0.27
|
| Rate for Payer: Galaxy Health WC |
$0.53
|
| Rate for Payer: Galaxy Health WC |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.58
|
| Rate for Payer: Global Benefits Group Commercial |
$0.41
|
| Rate for Payer: Global Benefits Group Commercial |
$0.37
|
| Rate for Payer: Global Benefits Group Commercial |
$0.20
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.61
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.56
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.39
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: Multiplan Commercial |
$0.51
|
| Rate for Payer: Multiplan Commercial |
$0.47
|
| Rate for Payer: Multiplan Commercial |
$0.25
|
| Rate for Payer: Networks By Design Commercial |
$0.34
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.31
|
| Rate for Payer: Prime Health Services Commercial |
$0.53
|
| Rate for Payer: Prime Health Services Commercial |
$0.58
|
| Rate for Payer: Prime Health Services Commercial |
$0.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.23
|
| Rate for Payer: United Healthcare All Other HMO |
$0.23
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.25
|
| Rate for Payer: United Healthcare HMO Rider |
$0.12
|
| Rate for Payer: United Healthcare HMO Rider |
$0.22
|
| Rate for Payer: United Healthcare HMO Rider |
$0.24
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.20
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.22
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
|
|
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [9316]
|
Facility
|
OP
|
$2.46
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.49 |
| Max. Negotiated Rate |
$2.21 |
| Rate for Payer: Adventist Health Commercial |
$0.49
|
| Rate for Payer: Aetna of CA HMO/PPO |
$1.49
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.09
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.35
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.84
|
| Rate for Payer: Blue Shield of California Commercial |
$1.56
|
| Rate for Payer: Blue Shield of California EPN |
$0.98
|
| Rate for Payer: Cash Price |
$1.11
|
| Rate for Payer: Central Health Plan Commercial |
$1.97
|
| Rate for Payer: Cigna of CA HMO |
$1.72
|
| Rate for Payer: Cigna of CA PPO |
$1.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.09
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.09
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.09
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.98
|
| Rate for Payer: EPIC Health Plan Senior |
$0.98
|
| Rate for Payer: Galaxy Health WC |
$2.09
|
| Rate for Payer: Global Benefits Group Commercial |
$1.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.49
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.72
|
| Rate for Payer: Multiplan Commercial |
$1.84
|
| Rate for Payer: Networks By Design Commercial |
$1.23
|
| Rate for Payer: Prime Health Services Commercial |
$2.09
|
| Rate for Payer: Riverside University Health System MISP |
$0.98
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.48
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.48
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.92
|
| Rate for Payer: United Healthcare All Other HMO |
$0.90
|
| Rate for Payer: United Healthcare HMO Rider |
$0.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.81
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.09
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.09
|
| Rate for Payer: Vantage Medical Group Senior |
$2.09
|
|
|
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) IN 8.25 % DEXTROSE INJECTION [9316]
|
Facility
|
IP
|
$2.46
|
|
|
Service Code
|
HCPCS J3490
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.49 |
| Max. Negotiated Rate |
$2.21 |
| Rate for Payer: Adventist Health Commercial |
$0.49
|
| Rate for Payer: Blue Shield of California Commercial |
$1.97
|
| Rate for Payer: Blue Shield of California EPN |
$1.24
|
| Rate for Payer: Cash Price |
$1.11
|
| Rate for Payer: Central Health Plan Commercial |
$1.97
|
| Rate for Payer: Cigna of CA HMO |
$1.72
|
| Rate for Payer: Cigna of CA PPO |
$1.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.98
|
| Rate for Payer: EPIC Health Plan Senior |
$0.98
|
| Rate for Payer: Galaxy Health WC |
$2.09
|
| Rate for Payer: Global Benefits Group Commercial |
$1.48
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.45
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.49
|
| Rate for Payer: Multiplan Commercial |
$1.84
|
| Rate for Payer: Networks By Design Commercial |
$1.23
|
| Rate for Payer: Prime Health Services Commercial |
$2.09
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.92
|
| Rate for Payer: United Healthcare All Other HMO |
$0.90
|
| Rate for Payer: United Healthcare HMO Rider |
$0.88
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.81
|
|
|
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION [1224]
|
Facility
|
OP
|
$0.32
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$8.49 |
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Adventist Health Commercial |
$0.14
|
| Rate for Payer: Adventist Health Commercial |
$0.13
|
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Adventist Health Commercial |
$0.04
|
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.27
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.26
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.17
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.19
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.35
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.47
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.25
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.53
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.26
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Cash Price |
$0.16
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Cash Price |
$0.16
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: Central Health Plan Commercial |
$0.26
|
| Rate for Payer: Central Health Plan Commercial |
$0.24
|
| Rate for Payer: Central Health Plan Commercial |
$0.50
|
| Rate for Payer: Central Health Plan Commercial |
$0.26
|
| Rate for Payer: Central Health Plan Commercial |
$0.57
|
| Rate for Payer: Central Health Plan Commercial |
$0.28
|
| Rate for Payer: Central Health Plan Commercial |
$0.15
|
| Rate for Payer: Cigna of CA HMO |
$0.23
|
| Rate for Payer: Cigna of CA HMO |
$0.25
|
| Rate for Payer: Cigna of CA HMO |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA HMO |
$0.44
|
| Rate for Payer: Cigna of CA HMO |
$0.21
|
| Rate for Payer: Cigna of CA HMO |
$0.13
|
| Rate for Payer: Cigna of CA PPO |
$0.23
|
| Rate for Payer: Cigna of CA PPO |
$0.13
|
| Rate for Payer: Cigna of CA PPO |
$0.21
|
| Rate for Payer: Cigna of CA PPO |
$0.25
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.22
|
| Rate for Payer: Cigna of CA PPO |
$0.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.26
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.54
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.60
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.30
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.54
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.26
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.30
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.27
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.60
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.26
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.54
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.16
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.30
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.60
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.25
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: EPIC Health Plan Senior |
$0.25
|
| Rate for Payer: EPIC Health Plan Senior |
$0.28
|
| Rate for Payer: EPIC Health Plan Senior |
$0.08
|
| Rate for Payer: EPIC Health Plan Senior |
$0.12
|
| Rate for Payer: EPIC Health Plan Senior |
$0.13
|
| Rate for Payer: EPIC Health Plan Senior |
$0.14
|
| Rate for Payer: EPIC Health Plan Senior |
$0.13
|
| Rate for Payer: Galaxy Health WC |
$0.30
|
| Rate for Payer: Galaxy Health WC |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.27
|
| Rate for Payer: Galaxy Health WC |
$0.54
|
| Rate for Payer: Galaxy Health WC |
$0.60
|
| Rate for Payer: Galaxy Health WC |
$0.26
|
| Rate for Payer: Galaxy Health WC |
$0.16
|
| Rate for Payer: Global Benefits Group Commercial |
$0.19
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Global Benefits Group Commercial |
$0.11
|
| Rate for Payer: Global Benefits Group Commercial |
$0.20
|
| Rate for Payer: Global Benefits Group Commercial |
$0.38
|
| Rate for Payer: Global Benefits Group Commercial |
$0.18
|
| Rate for Payer: Global Benefits Group Commercial |
$0.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.30
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.17
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.40
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$8.49
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.21
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.22
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.25
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.44
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.21
|
| Rate for Payer: Multiplan Commercial |
$0.53
|
| Rate for Payer: Multiplan Commercial |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.23
|
| Rate for Payer: Multiplan Commercial |
$0.47
|
| Rate for Payer: Multiplan Commercial |
$0.25
|
| Rate for Payer: Multiplan Commercial |
$0.14
|
| Rate for Payer: Multiplan Commercial |
$0.26
|
| Rate for Payer: Networks By Design Commercial |
$0.10
|
| Rate for Payer: Networks By Design Commercial |
$0.36
|
| Rate for Payer: Networks By Design Commercial |
$0.16
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.15
|
| Rate for Payer: Networks By Design Commercial |
$0.18
|
| Rate for Payer: Networks By Design Commercial |
$0.32
|
| Rate for Payer: Prime Health Services Commercial |
$0.28
|
| Rate for Payer: Prime Health Services Commercial |
$0.30
|
| Rate for Payer: Prime Health Services Commercial |
$0.26
|
| Rate for Payer: Prime Health Services Commercial |
$0.54
|
| Rate for Payer: Prime Health Services Commercial |
$0.16
|
| Rate for Payer: Prime Health Services Commercial |
$0.27
|
| Rate for Payer: Prime Health Services Commercial |
$0.60
|
| Rate for Payer: Riverside University Health System MISP |
$0.08
|
| Rate for Payer: Riverside University Health System MISP |
$0.14
|
| Rate for Payer: Riverside University Health System MISP |
$0.28
|
| Rate for Payer: Riverside University Health System MISP |
$0.13
|
| Rate for Payer: Riverside University Health System MISP |
$0.13
|
| Rate for Payer: Riverside University Health System MISP |
$0.25
|
| Rate for Payer: Riverside University Health System MISP |
$0.12
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.18
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.19
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.43
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.11
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.20
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.38
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.38
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.21
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.11
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.43
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.20
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.18
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.07
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.07
|
| Rate for Payer: United Healthcare All Other HMO |
$0.13
|
| Rate for Payer: United Healthcare All Other HMO |
$0.23
|
| Rate for Payer: United Healthcare All Other HMO |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.26
|
| Rate for Payer: United Healthcare HMO Rider |
$0.23
|
| Rate for Payer: United Healthcare HMO Rider |
$0.25
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.13
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.12
|
| Rate for Payer: United Healthcare HMO Rider |
$0.07
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.10
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.26
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.26
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.30
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.16
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.16
|
| Rate for Payer: Vantage Medical Group Senior |
$0.54
|
| Rate for Payer: Vantage Medical Group Senior |
$0.26
|
| Rate for Payer: Vantage Medical Group Senior |
$0.60
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.30
|
| Rate for Payer: Vantage Medical Group Senior |
$0.27
|
|
|
BUPIVACAINE (PF) 0.75 % (7.5 MG/ML) INJECTION SOLUTION [1224]
|
Facility
|
IP
|
$0.71
|
|
|
Service Code
|
HCPCS J0665
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.14 |
| Max. Negotiated Rate |
$0.64 |
| Rate for Payer: Adventist Health Commercial |
$0.14
|
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Adventist Health Commercial |
$0.04
|
| Rate for Payer: Adventist Health Commercial |
$0.06
|
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Adventist Health Commercial |
$0.13
|
| Rate for Payer: Blue Shield of California Commercial |
$0.57
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California Commercial |
$0.51
|
| Rate for Payer: Blue Shield of California Commercial |
$0.28
|
| Rate for Payer: Blue Shield of California Commercial |
$0.24
|
| Rate for Payer: Blue Shield of California Commercial |
$0.15
|
| Rate for Payer: Blue Shield of California Commercial |
$0.26
|
| Rate for Payer: Blue Shield of California EPN |
$0.17
|
| Rate for Payer: Blue Shield of California EPN |
$0.10
|
| Rate for Payer: Blue Shield of California EPN |
$0.16
|
| Rate for Payer: Blue Shield of California EPN |
$0.15
|
| Rate for Payer: Blue Shield of California EPN |
$0.36
|
| Rate for Payer: Blue Shield of California EPN |
$0.32
|
| Rate for Payer: Blue Shield of California EPN |
$0.18
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: Cash Price |
$0.15
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cash Price |
$0.14
|
| Rate for Payer: Cash Price |
$0.32
|
| Rate for Payer: Cash Price |
$0.16
|
| Rate for Payer: Central Health Plan Commercial |
$0.28
|
| Rate for Payer: Central Health Plan Commercial |
$0.26
|
| Rate for Payer: Central Health Plan Commercial |
$0.15
|
| Rate for Payer: Central Health Plan Commercial |
$0.50
|
| Rate for Payer: Central Health Plan Commercial |
$0.26
|
| Rate for Payer: Central Health Plan Commercial |
$0.24
|
| Rate for Payer: Central Health Plan Commercial |
$0.57
|
| Rate for Payer: Cigna of CA HMO |
$0.22
|
| Rate for Payer: Cigna of CA HMO |
$0.23
|
| Rate for Payer: Cigna of CA HMO |
$0.44
|
| Rate for Payer: Cigna of CA HMO |
$0.25
|
| Rate for Payer: Cigna of CA HMO |
$0.21
|
| Rate for Payer: Cigna of CA HMO |
$0.13
|
| Rate for Payer: Cigna of CA HMO |
$0.50
|
| Rate for Payer: Cigna of CA PPO |
$0.13
|
| Rate for Payer: Cigna of CA PPO |
$0.22
|
| Rate for Payer: Cigna of CA PPO |
$0.21
|
| Rate for Payer: Cigna of CA PPO |
$0.23
|
| Rate for Payer: Cigna of CA PPO |
$0.25
|
| Rate for Payer: Cigna of CA PPO |
$0.44
|
| Rate for Payer: Cigna of CA PPO |
$0.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.23
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.44
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.50
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.22
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.21
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.13
|
| Rate for Payer: EPIC Health Plan Senior |
$0.25
|
| Rate for Payer: EPIC Health Plan Senior |
$0.08
|
| Rate for Payer: EPIC Health Plan Senior |
$0.12
|
| Rate for Payer: EPIC Health Plan Senior |
$0.14
|
| Rate for Payer: EPIC Health Plan Senior |
$0.28
|
| Rate for Payer: EPIC Health Plan Senior |
$0.13
|
| Rate for Payer: EPIC Health Plan Senior |
$0.13
|
| Rate for Payer: Galaxy Health WC |
$0.30
|
| Rate for Payer: Galaxy Health WC |
$0.54
|
| Rate for Payer: Galaxy Health WC |
$0.28
|
| Rate for Payer: Galaxy Health WC |
$0.16
|
| Rate for Payer: Galaxy Health WC |
$0.27
|
| Rate for Payer: Galaxy Health WC |
$0.60
|
| Rate for Payer: Galaxy Health WC |
$0.26
|
| Rate for Payer: Global Benefits Group Commercial |
$0.18
|
| Rate for Payer: Global Benefits Group Commercial |
$0.43
|
| Rate for Payer: Global Benefits Group Commercial |
$0.20
|
| Rate for Payer: Global Benefits Group Commercial |
$0.38
|
| Rate for Payer: Global Benefits Group Commercial |
$0.11
|
| Rate for Payer: Global Benefits Group Commercial |
$0.19
|
| Rate for Payer: Global Benefits Group Commercial |
$0.21
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.64
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.27
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.29
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.17
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.57
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.32
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.30
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.45
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.12
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.21
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.22
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.40
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.37
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.42
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.18
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.11
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.24
|
| Rate for Payer: Multiplan Commercial |
$0.14
|
| Rate for Payer: Multiplan Commercial |
$0.25
|
| Rate for Payer: Multiplan Commercial |
$0.26
|
| Rate for Payer: Multiplan Commercial |
$0.47
|
| Rate for Payer: Multiplan Commercial |
$0.53
|
| Rate for Payer: Multiplan Commercial |
$0.23
|
| Rate for Payer: Networks By Design Commercial |
$0.18
|
| Rate for Payer: Networks By Design Commercial |
$0.36
|
| Rate for Payer: Networks By Design Commercial |
$0.10
|
| Rate for Payer: Networks By Design Commercial |
$0.17
|
| Rate for Payer: Networks By Design Commercial |
$0.15
|
| Rate for Payer: Networks By Design Commercial |
$0.16
|
| Rate for Payer: Networks By Design Commercial |
$0.32
|
| Rate for Payer: Prime Health Services Commercial |
$0.16
|
| Rate for Payer: Prime Health Services Commercial |
$0.27
|
| Rate for Payer: Prime Health Services Commercial |
$0.26
|
| Rate for Payer: Prime Health Services Commercial |
$0.60
|
| Rate for Payer: Prime Health Services Commercial |
$0.54
|
| Rate for Payer: Prime Health Services Commercial |
$0.30
|
| Rate for Payer: Prime Health Services Commercial |
$0.28
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.27
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.24
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.12
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.07
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.07
|
| Rate for Payer: United Healthcare All Other HMO |
$0.13
|
| Rate for Payer: United Healthcare All Other HMO |
$0.23
|
| Rate for Payer: United Healthcare All Other HMO |
$0.12
|
| Rate for Payer: United Healthcare All Other HMO |
$0.26
|
| Rate for Payer: United Healthcare HMO Rider |
$0.07
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.13
|
| Rate for Payer: United Healthcare HMO Rider |
$0.25
|
| Rate for Payer: United Healthcare HMO Rider |
$0.23
|
| Rate for Payer: United Healthcare HMO Rider |
$0.12
|
| Rate for Payer: United Healthcare HMO Rider |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.11
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.06
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.10
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.23
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.21
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.10
|
|
|
BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH [107661]
|
Facility
|
OP
|
$95.32
|
|
|
Service Code
|
NDC 0093365740
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$19.06 |
| Max. Negotiated Rate |
$85.79 |
| Rate for Payer: Adventist Health Commercial |
$19.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.45
|
| Rate for Payer: Blue Shield of California Commercial |
$60.43
|
| Rate for Payer: Blue Shield of California EPN |
$38.03
|
| Rate for Payer: Cash Price |
$42.89
|
| Rate for Payer: Central Health Plan Commercial |
$76.26
|
| Rate for Payer: Cigna of CA HMO |
$66.72
|
| Rate for Payer: Cigna of CA PPO |
$66.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.13
|
| Rate for Payer: EPIC Health Plan Senior |
$38.13
|
| Rate for Payer: Galaxy Health WC |
$81.02
|
| Rate for Payer: Global Benefits Group Commercial |
$57.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$66.72
|
| Rate for Payer: Multiplan Commercial |
$71.49
|
| Rate for Payer: Networks By Design Commercial |
$61.96
|
| Rate for Payer: Prime Health Services Commercial |
$81.02
|
| Rate for Payer: Riverside University Health System MISP |
$38.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.66
|
| Rate for Payer: United Healthcare All Other HMO |
$47.66
|
| Rate for Payer: United Healthcare HMO Rider |
$47.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.02
|
| Rate for Payer: Vantage Medical Group Senior |
$81.02
|
|
|
BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH [107661]
|
Facility
|
IP
|
$95.32
|
|
|
Service Code
|
NDC 0093365721
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$19.06 |
| Max. Negotiated Rate |
$85.79 |
| Rate for Payer: Adventist Health Commercial |
$19.06
|
| Rate for Payer: Blue Shield of California Commercial |
$76.45
|
| Rate for Payer: Blue Shield of California EPN |
$48.04
|
| Rate for Payer: Cash Price |
$42.89
|
| Rate for Payer: Central Health Plan Commercial |
$76.26
|
| Rate for Payer: Cigna of CA HMO |
$66.72
|
| Rate for Payer: Cigna of CA PPO |
$66.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.13
|
| Rate for Payer: EPIC Health Plan Senior |
$38.13
|
| Rate for Payer: Galaxy Health WC |
$81.02
|
| Rate for Payer: Global Benefits Group Commercial |
$57.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.06
|
| Rate for Payer: Multiplan Commercial |
$71.49
|
| Rate for Payer: Networks By Design Commercial |
$61.96
|
| Rate for Payer: Prime Health Services Commercial |
$81.02
|
|
|
BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH [107661]
|
Facility
|
IP
|
$95.32
|
|
|
Service Code
|
NDC 0093365740
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$19.06 |
| Max. Negotiated Rate |
$85.79 |
| Rate for Payer: Adventist Health Commercial |
$19.06
|
| Rate for Payer: Blue Shield of California Commercial |
$76.45
|
| Rate for Payer: Blue Shield of California EPN |
$48.04
|
| Rate for Payer: Cash Price |
$42.89
|
| Rate for Payer: Central Health Plan Commercial |
$76.26
|
| Rate for Payer: Cigna of CA HMO |
$66.72
|
| Rate for Payer: Cigna of CA PPO |
$66.72
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.13
|
| Rate for Payer: EPIC Health Plan Senior |
$38.13
|
| Rate for Payer: Galaxy Health WC |
$81.02
|
| Rate for Payer: Global Benefits Group Commercial |
$57.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.06
|
| Rate for Payer: Multiplan Commercial |
$71.49
|
| Rate for Payer: Networks By Design Commercial |
$61.96
|
| Rate for Payer: Prime Health Services Commercial |
$81.02
|
|
|
BUPRENORPHINE 10 MCG/HOUR WEEKLY TRANSDERMAL PATCH [107661]
|
Facility
|
OP
|
$95.32
|
|
|
Service Code
|
NDC 0093365721
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$19.06 |
| Max. Negotiated Rate |
$85.79 |
| Rate for Payer: Adventist Health Commercial |
$19.06
|
| Rate for Payer: Aetna of CA HMO/PPO |
$57.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$81.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$52.43
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$71.49
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$46.15
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$55.45
|
| Rate for Payer: Blue Shield of California Commercial |
$60.43
|
| Rate for Payer: Blue Shield of California EPN |
$38.03
|
| Rate for Payer: Cash Price |
$42.89
|
| Rate for Payer: Central Health Plan Commercial |
$76.26
|
| Rate for Payer: Cigna of CA HMO |
$66.72
|
| Rate for Payer: Cigna of CA PPO |
$66.72
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$81.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$81.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$81.02
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$66.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$38.13
|
| Rate for Payer: EPIC Health Plan Senior |
$38.13
|
| Rate for Payer: Galaxy Health WC |
$81.02
|
| Rate for Payer: Global Benefits Group Commercial |
$57.19
|
| Rate for Payer: Health Management Network EPO/PPO |
$85.79
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$60.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$34.60
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$56.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$66.72
|
| Rate for Payer: Multiplan Commercial |
$71.49
|
| Rate for Payer: Networks By Design Commercial |
$61.96
|
| Rate for Payer: Prime Health Services Commercial |
$81.02
|
| Rate for Payer: Riverside University Health System MISP |
$38.13
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$57.19
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$57.19
|
| Rate for Payer: United Healthcare All Other Commercial |
$47.66
|
| Rate for Payer: United Healthcare All Other HMO |
$47.66
|
| Rate for Payer: United Healthcare HMO Rider |
$47.66
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$47.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$81.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$81.02
|
| Rate for Payer: Vantage Medical Group Senior |
$81.02
|
|
|
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM [106176]
|
Facility
|
OP
|
$1.67
|
|
|
Service Code
|
HCPCS J0572
|
| Hospital Charge Code |
901700054
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$23.93 |
| Rate for Payer: Adventist Health Commercial |
$0.33
|
| Rate for Payer: Adventist Health Commercial |
$0.53
|
| Rate for Payer: Adventist Health Commercial |
$0.16
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.69
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.42
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.27
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.00
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.25
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.64
|
| Rate for Payer: Blue Shield of California Commercial |
$3.42
|
| Rate for Payer: Blue Shield of California Commercial |
$3.42
|
| Rate for Payer: Blue Shield of California Commercial |
$3.42
|
| Rate for Payer: Blue Shield of California EPN |
$3.11
|
| Rate for Payer: Blue Shield of California EPN |
$3.11
|
| Rate for Payer: Blue Shield of California EPN |
$3.11
|
| Rate for Payer: Cash Price |
$0.36
|
| Rate for Payer: Cash Price |
$0.36
|
| Rate for Payer: Cash Price |
$0.75
|
| Rate for Payer: Cash Price |
$0.75
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Central Health Plan Commercial |
$0.65
|
| Rate for Payer: Central Health Plan Commercial |
$1.34
|
| Rate for Payer: Central Health Plan Commercial |
$2.14
|
| Rate for Payer: Cigna of CA HMO |
$0.57
|
| Rate for Payer: Cigna of CA HMO |
$1.87
|
| Rate for Payer: Cigna of CA HMO |
$1.17
|
| Rate for Payer: Cigna of CA PPO |
$0.57
|
| Rate for Payer: Cigna of CA PPO |
$1.17
|
| Rate for Payer: Cigna of CA PPO |
$1.87
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.69
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.42
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.27
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.42
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.27
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.07
|
| Rate for Payer: EPIC Health Plan Senior |
$1.07
|
| Rate for Payer: EPIC Health Plan Senior |
$0.67
|
| Rate for Payer: EPIC Health Plan Senior |
$0.32
|
| Rate for Payer: Galaxy Health WC |
$2.27
|
| Rate for Payer: Galaxy Health WC |
$1.42
|
| Rate for Payer: Galaxy Health WC |
$0.69
|
| Rate for Payer: Global Benefits Group Commercial |
$1.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1.00
|
| Rate for Payer: Global Benefits Group Commercial |
$0.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.50
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.06
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.51
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.16
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.57
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.87
|
| Rate for Payer: Multiplan Commercial |
$0.61
|
| Rate for Payer: Multiplan Commercial |
$1.25
|
| Rate for Payer: Multiplan Commercial |
$2.00
|
| Rate for Payer: Networks By Design Commercial |
$0.84
|
| Rate for Payer: Networks By Design Commercial |
$0.41
|
| Rate for Payer: Networks By Design Commercial |
$1.33
|
| Rate for Payer: Prime Health Services Commercial |
$2.27
|
| Rate for Payer: Prime Health Services Commercial |
$1.42
|
| Rate for Payer: Prime Health Services Commercial |
$0.69
|
| Rate for Payer: Riverside University Health System MISP |
$0.67
|
| Rate for Payer: Riverside University Health System MISP |
$1.07
|
| Rate for Payer: Riverside University Health System MISP |
$0.32
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.00
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.60
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.49
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.00
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.60
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.63
|
| Rate for Payer: United Healthcare All Other HMO |
$0.98
|
| Rate for Payer: United Healthcare All Other HMO |
$0.61
|
| Rate for Payer: United Healthcare All Other HMO |
$0.30
|
| Rate for Payer: United Healthcare HMO Rider |
$0.60
|
| Rate for Payer: United Healthcare HMO Rider |
$0.95
|
| Rate for Payer: United Healthcare HMO Rider |
$0.29
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.27
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.69
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.42
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.27
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.69
|
| Rate for Payer: Vantage Medical Group Senior |
$2.27
|
| Rate for Payer: Vantage Medical Group Senior |
$0.69
|
| Rate for Payer: Vantage Medical Group Senior |
$1.42
|
|
|
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL FILM [106176]
|
Facility
|
IP
|
$2.67
|
|
|
Service Code
|
HCPCS J0572
|
| Hospital Charge Code |
901700054
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.53 |
| Max. Negotiated Rate |
$2.40 |
| Rate for Payer: Adventist Health Commercial |
$0.53
|
| Rate for Payer: Adventist Health Commercial |
$0.33
|
| Rate for Payer: Adventist Health Commercial |
$0.16
|
| Rate for Payer: Blue Shield of California Commercial |
$2.14
|
| Rate for Payer: Blue Shield of California Commercial |
$1.34
|
| Rate for Payer: Blue Shield of California Commercial |
$0.65
|
| Rate for Payer: Blue Shield of California EPN |
$0.41
|
| Rate for Payer: Blue Shield of California EPN |
$1.35
|
| Rate for Payer: Blue Shield of California EPN |
$0.84
|
| Rate for Payer: Cash Price |
$1.20
|
| Rate for Payer: Cash Price |
$0.36
|
| Rate for Payer: Cash Price |
$0.75
|
| Rate for Payer: Central Health Plan Commercial |
$1.34
|
| Rate for Payer: Central Health Plan Commercial |
$0.65
|
| Rate for Payer: Central Health Plan Commercial |
$2.14
|
| Rate for Payer: Cigna of CA HMO |
$1.87
|
| Rate for Payer: Cigna of CA HMO |
$0.57
|
| Rate for Payer: Cigna of CA HMO |
$1.17
|
| Rate for Payer: Cigna of CA PPO |
$1.87
|
| Rate for Payer: Cigna of CA PPO |
$1.17
|
| Rate for Payer: Cigna of CA PPO |
$0.57
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.87
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$1.17
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.07
|
| Rate for Payer: EPIC Health Plan Senior |
$0.67
|
| Rate for Payer: EPIC Health Plan Senior |
$0.32
|
| Rate for Payer: EPIC Health Plan Senior |
$1.07
|
| Rate for Payer: Galaxy Health WC |
$1.42
|
| Rate for Payer: Galaxy Health WC |
$0.69
|
| Rate for Payer: Galaxy Health WC |
$2.27
|
| Rate for Payer: Global Benefits Group Commercial |
$1.60
|
| Rate for Payer: Global Benefits Group Commercial |
$1.00
|
| Rate for Payer: Global Benefits Group Commercial |
$0.49
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.40
|
| Rate for Payer: Health Management Network EPO/PPO |
$0.73
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.50
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.51
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.58
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.99
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.16
|
| Rate for Payer: Multiplan Commercial |
$2.00
|
| Rate for Payer: Multiplan Commercial |
$1.25
|
| Rate for Payer: Multiplan Commercial |
$0.61
|
| Rate for Payer: Networks By Design Commercial |
$1.33
|
| Rate for Payer: Networks By Design Commercial |
$0.41
|
| Rate for Payer: Networks By Design Commercial |
$0.84
|
| Rate for Payer: Prime Health Services Commercial |
$1.42
|
| Rate for Payer: Prime Health Services Commercial |
$2.27
|
| Rate for Payer: Prime Health Services Commercial |
$0.69
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.30
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.63
|
| Rate for Payer: United Healthcare All Other HMO |
$0.61
|
| Rate for Payer: United Healthcare All Other HMO |
$0.30
|
| Rate for Payer: United Healthcare All Other HMO |
$0.98
|
| Rate for Payer: United Healthcare HMO Rider |
$0.29
|
| Rate for Payer: United Healthcare HMO Rider |
$0.60
|
| Rate for Payer: United Healthcare HMO Rider |
$0.95
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.55
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.87
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.27
|
|
|
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET [34713]
|
Facility
|
OP
|
$1.33
|
|
|
Service Code
|
HCPCS J0572
|
| Hospital Charge Code |
901700054
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.27 |
| Max. Negotiated Rate |
$23.93 |
| Rate for Payer: Adventist Health Commercial |
$0.27
|
| Rate for Payer: Adventist Health Commercial |
$0.61
|
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.93
|
| Rate for Payer: Aetna of CA HMO/PPO |
$23.93
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.94
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.13
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.58
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.67
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.61
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.00
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.93
|
| Rate for Payer: Anthem Blue Cross of CA Exchange |
$6.93
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.64
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$8.64
|
| Rate for Payer: Blue Shield of California Commercial |
$3.42
|
| Rate for Payer: Blue Shield of California Commercial |
$3.42
|
| Rate for Payer: Blue Shield of California Commercial |
$3.42
|
| Rate for Payer: Blue Shield of California EPN |
$3.11
|
| Rate for Payer: Blue Shield of California EPN |
$3.11
|
| Rate for Payer: Blue Shield of California EPN |
$3.11
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Cash Price |
$1.37
|
| Rate for Payer: Cash Price |
$1.37
|
| Rate for Payer: Central Health Plan Commercial |
$0.89
|
| Rate for Payer: Central Health Plan Commercial |
$1.06
|
| Rate for Payer: Central Health Plan Commercial |
$2.43
|
| Rate for Payer: Cigna of CA HMO |
$0.78
|
| Rate for Payer: Cigna of CA HMO |
$2.13
|
| Rate for Payer: Cigna of CA HMO |
$0.93
|
| Rate for Payer: Cigna of CA PPO |
$0.78
|
| Rate for Payer: Cigna of CA PPO |
$0.93
|
| Rate for Payer: Cigna of CA PPO |
$2.13
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.58
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.94
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.13
|
| Rate for Payer: Dignity Health Medicare Advantage |
$2.58
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.22
|
| Rate for Payer: EPIC Health Plan Senior |
$1.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.53
|
| Rate for Payer: EPIC Health Plan Senior |
$0.44
|
| Rate for Payer: Galaxy Health WC |
$2.58
|
| Rate for Payer: Galaxy Health WC |
$1.13
|
| Rate for Payer: Galaxy Health WC |
$0.94
|
| Rate for Payer: Global Benefits Group Commercial |
$1.82
|
| Rate for Payer: Global Benefits Group Commercial |
$0.80
|
| Rate for Payer: Global Benefits Group Commercial |
$0.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.20
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.41
|
| Rate for Payer: Inland Empire Health Plan (IEHP) medi-cal |
$2.41
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.84
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.70
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$2.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.93
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.78
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$2.13
|
| Rate for Payer: Multiplan Commercial |
$0.83
|
| Rate for Payer: Multiplan Commercial |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$2.28
|
| Rate for Payer: Networks By Design Commercial |
$0.67
|
| Rate for Payer: Networks By Design Commercial |
$0.56
|
| Rate for Payer: Networks By Design Commercial |
$1.52
|
| Rate for Payer: Prime Health Services Commercial |
$2.58
|
| Rate for Payer: Prime Health Services Commercial |
$1.13
|
| Rate for Payer: Prime Health Services Commercial |
$0.94
|
| Rate for Payer: Riverside University Health System MISP |
$0.53
|
| Rate for Payer: Riverside University Health System MISP |
$1.22
|
| Rate for Payer: Riverside University Health System MISP |
$0.44
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.80
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$1.82
|
| Rate for Payer: Temecula Valley Physicians Medical Group Commercial |
$0.67
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.80
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$1.82
|
| Rate for Payer: TriValley Medical Group Commercial/Senior |
$0.67
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.50
|
| Rate for Payer: United Healthcare All Other HMO |
$1.11
|
| Rate for Payer: United Healthcare All Other HMO |
$0.49
|
| Rate for Payer: United Healthcare All Other HMO |
$0.41
|
| Rate for Payer: United Healthcare HMO Rider |
$0.48
|
| Rate for Payer: United Healthcare HMO Rider |
$1.09
|
| Rate for Payer: United Healthcare HMO Rider |
$0.40
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.36
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.44
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.58
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.94
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.94
|
| Rate for Payer: Vantage Medical Group Senior |
$2.58
|
| Rate for Payer: Vantage Medical Group Senior |
$0.94
|
| Rate for Payer: Vantage Medical Group Senior |
$1.13
|
|
|
BUPRENORPHINE 2 MG-NALOXONE 0.5 MG SUBLINGUAL TABLET [34713]
|
Facility
|
IP
|
$3.04
|
|
|
Service Code
|
HCPCS J0572
|
| Hospital Charge Code |
901700054
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.61 |
| Max. Negotiated Rate |
$2.74 |
| Rate for Payer: Adventist Health Commercial |
$0.61
|
| Rate for Payer: Adventist Health Commercial |
$0.27
|
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$2.44
|
| Rate for Payer: Blue Shield of California Commercial |
$1.07
|
| Rate for Payer: Blue Shield of California Commercial |
$0.89
|
| Rate for Payer: Blue Shield of California EPN |
$0.56
|
| Rate for Payer: Blue Shield of California EPN |
$1.53
|
| Rate for Payer: Blue Shield of California EPN |
$0.67
|
| Rate for Payer: Cash Price |
$1.37
|
| Rate for Payer: Cash Price |
$0.50
|
| Rate for Payer: Cash Price |
$0.60
|
| Rate for Payer: Central Health Plan Commercial |
$1.06
|
| Rate for Payer: Central Health Plan Commercial |
$0.89
|
| Rate for Payer: Central Health Plan Commercial |
$2.43
|
| Rate for Payer: Cigna of CA HMO |
$2.13
|
| Rate for Payer: Cigna of CA HMO |
$0.78
|
| Rate for Payer: Cigna of CA HMO |
$0.93
|
| Rate for Payer: Cigna of CA PPO |
$2.13
|
| Rate for Payer: Cigna of CA PPO |
$0.93
|
| Rate for Payer: Cigna of CA PPO |
$0.78
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$2.13
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.93
|
| Rate for Payer: Emerging Therapy Solutions (LifeTrac) Transplant |
$0.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.22
|
| Rate for Payer: EPIC Health Plan Senior |
$0.53
|
| Rate for Payer: EPIC Health Plan Senior |
$0.44
|
| Rate for Payer: EPIC Health Plan Senior |
$1.22
|
| Rate for Payer: Galaxy Health WC |
$1.13
|
| Rate for Payer: Galaxy Health WC |
$0.94
|
| Rate for Payer: Galaxy Health WC |
$2.58
|
| Rate for Payer: Global Benefits Group Commercial |
$1.82
|
| Rate for Payer: Global Benefits Group Commercial |
$0.80
|
| Rate for Payer: Global Benefits Group Commercial |
$0.67
|
| Rate for Payer: Health Management Network EPO/PPO |
$2.74
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.00
|
| Rate for Payer: Health Management Network EPO/PPO |
$1.20
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.70
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$1.93
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial/Self Funded |
$0.84
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$1.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.78
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$0.65
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.22
|
| Rate for Payer: Multiplan Commercial |
$2.28
|
| Rate for Payer: Multiplan Commercial |
$1.00
|
| Rate for Payer: Multiplan Commercial |
$0.83
|
| Rate for Payer: Networks By Design Commercial |
$1.52
|
| Rate for Payer: Networks By Design Commercial |
$0.56
|
| Rate for Payer: Networks By Design Commercial |
$0.67
|
| Rate for Payer: Prime Health Services Commercial |
$1.13
|
| Rate for Payer: Prime Health Services Commercial |
$2.58
|
| Rate for Payer: Prime Health Services Commercial |
$0.94
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.42
|
| Rate for Payer: United Healthcare All Other Commercial |
$1.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$0.50
|
| Rate for Payer: United Healthcare All Other HMO |
$0.49
|
| Rate for Payer: United Healthcare All Other HMO |
$0.41
|
| Rate for Payer: United Healthcare All Other HMO |
$1.11
|
| Rate for Payer: United Healthcare HMO Rider |
$0.40
|
| Rate for Payer: United Healthcare HMO Rider |
$0.48
|
| Rate for Payer: United Healthcare HMO Rider |
$1.09
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.44
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$1.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$0.36
|
|
