|
METHYLPREDNISOLONE 16 MG TABLET [4992]
|
Facility
|
IP
|
$2.98
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.54 |
| Max. Negotiated Rate |
$2.23 |
| Rate for Payer: Adventist Health Commercial |
$0.60
|
| Rate for Payer: Adventist Health Commercial |
$0.68
|
| Rate for Payer: Cash Price |
$1.87
|
| Rate for Payer: Cash Price |
$1.64
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.37
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.61
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.57
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.38
|
| Rate for Payer: Heritage Provider Network Senior |
$1.38
|
| Rate for Payer: Heritage Provider Network Senior |
$1.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.85
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.75
|
| Rate for Payer: Multiplan Commercial |
$2.55
|
| Rate for Payer: Multiplan Commercial |
$2.23
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.08
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.23
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.13
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.99
|
|
|
METHYLPREDNISOLONE 32 MG TABLET [10575]
|
Facility
|
OP
|
$4.96
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$4.22 |
| Rate for Payer: Adventist Health Commercial |
$0.99
|
| Rate for Payer: Adventist Health Commercial |
$0.89
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2.37
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3.41
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.22
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$3.77
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.73
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$2.44
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.72
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$3.33
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: Cash Price |
$2.44
|
| Rate for Payer: Cash Price |
$2.44
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.04
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.28
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$3.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.22
|
| Rate for Payer: Dignity Health Medi-Cal |
$3.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.22
|
| Rate for Payer: Dignity Health Senior |
$3.77
|
| Rate for Payer: Dignity Health Senior |
$4.22
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.06
|
| Rate for Payer: Heritage Provider Network Senior |
$2.06
|
| Rate for Payer: Heritage Provider Network Senior |
$2.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.80
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.24
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.47
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$3.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$3.47
|
| Rate for Payer: Multiplan Commercial |
$3.72
|
| Rate for Payer: Multiplan Commercial |
$3.33
|
| Rate for Payer: TriValley Medical Group Commercial |
$1.98
|
| Rate for Payer: TriValley Medical Group Commercial |
$1.78
|
| Rate for Payer: TriValley Medical Group Senior |
$1.78
|
| Rate for Payer: TriValley Medical Group Senior |
$1.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.79
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.47
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$3.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$3.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.22
|
| Rate for Payer: Vantage Medical Group Senior |
$3.77
|
| Rate for Payer: Vantage Medical Group Senior |
$4.22
|
|
|
METHYLPREDNISOLONE 32 MG TABLET [10575]
|
Facility
|
IP
|
$4.44
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.80 |
| Max. Negotiated Rate |
$3.33 |
| Rate for Payer: Adventist Health Commercial |
$0.89
|
| Rate for Payer: Adventist Health Commercial |
$0.99
|
| Rate for Payer: Cash Price |
$2.73
|
| Rate for Payer: Cash Price |
$2.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.04
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.30
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.06
|
| Rate for Payer: Heritage Provider Network Senior |
$2.06
|
| Rate for Payer: Heritage Provider Network Senior |
$2.30
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.24
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.11
|
| Rate for Payer: Multiplan Commercial |
$3.72
|
| Rate for Payer: Multiplan Commercial |
$3.33
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.79
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.47
|
|
|
METHYLPREDNISOLONE 40 MG INJ. [4081204]
|
Facility
|
IP
|
$7.30
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.32 |
| Max. Negotiated Rate |
$5.47 |
| Rate for Payer: Adventist Health Commercial |
$1.46
|
| Rate for Payer: Adventist Health Commercial |
$0.98
|
| Rate for Payer: Adventist Health Commercial |
$1.55
|
| Rate for Payer: Cash Price |
$4.01
|
| Rate for Payer: Cash Price |
$4.27
|
| Rate for Payer: Cash Price |
$2.69
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.57
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.36
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.38
|
| Rate for Payer: Heritage Provider Network Senior |
$3.38
|
| Rate for Payer: Heritage Provider Network Senior |
$2.27
|
| Rate for Payer: Heritage Provider Network Senior |
$3.59
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.40
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.23
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.94
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: Multiplan Commercial |
$3.67
|
| Rate for Payer: Multiplan Commercial |
$5.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.57
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.62
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.42
|
|
|
METHYLPREDNISOLONE 40 MG INJ. [4081204]
|
Facility
|
OP
|
$7.76
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$5.82 |
| Rate for Payer: Adventist Health Commercial |
$1.55
|
| Rate for Payer: Adventist Health Commercial |
$0.98
|
| Rate for Payer: Adventist Health Commercial |
$1.46
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4.15
|
| Rate for Payer: Aetna of CA Gatekeeper |
$2.62
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.02
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| 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 |
$0.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Cash Price |
$4.01
|
| Rate for Payer: Cash Price |
$4.01
|
| Rate for Payer: Cash Price |
$2.69
|
| Rate for Payer: Cash Price |
$4.27
|
| Rate for Payer: Cash Price |
$2.69
|
| Rate for Payer: Cash Price |
$4.27
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.36
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.25
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.57
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.67
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.97
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.27
|
| Rate for Payer: Heritage Provider Network Senior |
$3.38
|
| Rate for Payer: Heritage Provider Network Senior |
$3.59
|
| Rate for Payer: Heritage Provider Network Senior |
$2.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3.70
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.82
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.23
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Multiplan Commercial |
$5.47
|
| Rate for Payer: Multiplan Commercial |
$3.67
|
| Rate for Payer: Multiplan Commercial |
$5.82
|
| Rate for Payer: TriValley Medical Group Commercial |
$2.92
|
| Rate for Payer: TriValley Medical Group Commercial |
$1.96
|
| Rate for Payer: TriValley Medical Group Commercial |
$3.10
|
| Rate for Payer: TriValley Medical Group Senior |
$1.96
|
| Rate for Payer: TriValley Medical Group Senior |
$2.92
|
| Rate for Payer: TriValley Medical Group Senior |
$3.10
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.80
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.62
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.42
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.57
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
|
|
METHYLPREDNISOLONE 4 MG TABLET [4993]
|
Facility
|
OP
|
$1.03
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.19 |
| Max. Negotiated Rate |
$0.88 |
| Rate for Payer: Adventist Health Commercial |
$0.21
|
| Rate for Payer: Adventist Health Commercial |
$0.40
|
| Rate for Payer: Adventist Health Commercial |
$0.45
|
| Rate for Payer: Adventist Health Commercial |
$0.08
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.19
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.07
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.55
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.53
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.71
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.90
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.88
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.70
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.10
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.21
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.57
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.23
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.67
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.77
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.29
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: Cash Price |
$0.21
|
| Rate for Payer: Cash Price |
$0.57
|
| Rate for Payer: Cash Price |
$0.57
|
| Rate for Payer: Cash Price |
$0.21
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: Cash Price |
$1.10
|
| Rate for Payer: Cash Price |
$1.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.17
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.47
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.70
|
| Rate for Payer: Dignity Health Senior |
$1.70
|
| Rate for Payer: Dignity Health Senior |
$1.90
|
| Rate for Payer: Dignity Health Senior |
$0.88
|
| Rate for Payer: Dignity Health Senior |
$0.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.66
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.43
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.18
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.03
|
| Rate for Payer: Heritage Provider Network Senior |
$1.03
|
| Rate for Payer: Heritage Provider Network Senior |
$0.18
|
| Rate for Payer: Heritage Provider Network Senior |
$0.48
|
| Rate for Payer: Heritage Provider Network Senior |
$0.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.95
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1.06
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.19
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.36
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.56
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.72
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.72
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.40
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.56
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Multiplan Commercial |
$0.77
|
| Rate for Payer: Multiplan Commercial |
$1.50
|
| Rate for Payer: Multiplan Commercial |
$0.29
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.15
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.89
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.80
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.41
|
| Rate for Payer: TriValley Medical Group Senior |
$0.89
|
| Rate for Payer: TriValley Medical Group Senior |
$0.41
|
| Rate for Payer: TriValley Medical Group Senior |
$0.15
|
| Rate for Payer: TriValley Medical Group Senior |
$0.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.72
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.13
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.70
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.70
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.88
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.90
|
| Rate for Payer: Vantage Medical Group Senior |
$0.32
|
| Rate for Payer: Vantage Medical Group Senior |
$0.88
|
| Rate for Payer: Vantage Medical Group Senior |
$1.70
|
| Rate for Payer: Vantage Medical Group Senior |
$1.90
|
|
|
METHYLPREDNISOLONE 4 MG TABLET [4993]
|
Facility
|
IP
|
$2.00
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.36 |
| Max. Negotiated Rate |
$1.50 |
| Rate for Payer: Adventist Health Commercial |
$0.40
|
| Rate for Payer: Adventist Health Commercial |
$0.45
|
| Rate for Payer: Adventist Health Commercial |
$0.08
|
| Rate for Payer: Adventist Health Commercial |
$0.21
|
| Rate for Payer: Cash Price |
$0.57
|
| Rate for Payer: Cash Price |
$1.10
|
| Rate for Payer: Cash Price |
$1.22
|
| Rate for Payer: Cash Price |
$0.21
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.92
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.47
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.21
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.56
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.93
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.48
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.18
|
| Rate for Payer: Heritage Provider Network Senior |
$1.03
|
| Rate for Payer: Heritage Provider Network Senior |
$0.18
|
| Rate for Payer: Heritage Provider Network Senior |
$0.48
|
| Rate for Payer: Heritage Provider Network Senior |
$0.93
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.36
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.40
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.19
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.50
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.10
|
| Rate for Payer: Multiplan Commercial |
$0.29
|
| Rate for Payer: Multiplan Commercial |
$1.67
|
| Rate for Payer: Multiplan Commercial |
$1.50
|
| Rate for Payer: Multiplan Commercial |
$0.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.72
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.81
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.34
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.13
|
|
|
METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [4991]
|
Facility
|
OP
|
$1.37
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$1.16 |
| Rate for Payer: Adventist Health Commercial |
$0.27
|
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.20
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.73
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.94
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.16
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.31
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.75
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.20
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Cash Price |
$0.75
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cash Price |
$0.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.17
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.63
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.31
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.16
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.31
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.16
|
| Rate for Payer: Dignity Health Senior |
$0.31
|
| Rate for Payer: Dignity Health Senior |
$1.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.24
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.17
|
| Rate for Payer: Heritage Provider Network Senior |
$0.17
|
| Rate for Payer: Heritage Provider Network Senior |
$0.63
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.65
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.18
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.07
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.96
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.96
|
| Rate for Payer: Multiplan Commercial |
$1.03
|
| Rate for Payer: Multiplan Commercial |
$0.28
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.55
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.15
|
| Rate for Payer: TriValley Medical Group Senior |
$0.15
|
| Rate for Payer: TriValley Medical Group Senior |
$0.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.49
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.13
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.45
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.16
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.31
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.16
|
| Rate for Payer: Vantage Medical Group Senior |
$0.31
|
| Rate for Payer: Vantage Medical Group Senior |
$1.16
|
|
|
METHYLPREDNISOLONE 4 MG TABLETS IN A DOSE PACK [4991]
|
Facility
|
IP
|
$0.37
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.07 |
| Max. Negotiated Rate |
$0.28 |
| Rate for Payer: Adventist Health Commercial |
$0.07
|
| Rate for Payer: Adventist Health Commercial |
$0.27
|
| Rate for Payer: Cash Price |
$0.75
|
| Rate for Payer: Cash Price |
$0.20
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.17
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.17
|
| Rate for Payer: Heritage Provider Network Senior |
$0.17
|
| Rate for Payer: Heritage Provider Network Senior |
$0.63
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.25
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.09
|
| Rate for Payer: Multiplan Commercial |
$1.03
|
| Rate for Payer: Multiplan Commercial |
$0.28
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.45
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.12
|
|
|
METHYLPREDNISOLONE 500 MG INJ WRAP FOR CNR USE ONLY [4081203]
|
Facility
|
OP
|
$29.14
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$21.86 |
| Rate for Payer: Adventist Health Commercial |
$5.83
|
| Rate for Payer: Adventist Health Commercial |
$11.37
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.58
|
| Rate for Payer: Aetna of CA Gatekeeper |
$30.39
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39.06
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| 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 EPN |
$0.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Cash Price |
$31.27
|
| Rate for Payer: Cash Price |
$16.02
|
| Rate for Payer: Cash Price |
$31.27
|
| Rate for Payer: Cash Price |
$16.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.65
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.39
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.33
|
| Rate for Payer: Heritage Provider Network Senior |
$13.49
|
| Rate for Payer: Heritage Provider Network Senior |
$26.33
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$27.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.21
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Multiplan Commercial |
$21.86
|
| Rate for Payer: Multiplan Commercial |
$42.65
|
| Rate for Payer: TriValley Medical Group Commercial |
$22.74
|
| Rate for Payer: TriValley Medical Group Commercial |
$11.66
|
| Rate for Payer: TriValley Medical Group Senior |
$11.66
|
| Rate for Payer: TriValley Medical Group Senior |
$22.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.54
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.53
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.65
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.83
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
|
|
METHYLPREDNISOLONE 500 MG INJ WRAP FOR CNR USE ONLY [4081203]
|
Facility
|
IP
|
$56.86
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.29 |
| Max. Negotiated Rate |
$42.65 |
| Rate for Payer: Adventist Health Commercial |
$11.37
|
| Rate for Payer: Adventist Health Commercial |
$5.83
|
| Rate for Payer: Cash Price |
$31.27
|
| Rate for Payer: Cash Price |
$16.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$26.16
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.33
|
| Rate for Payer: Heritage Provider Network Senior |
$26.33
|
| Rate for Payer: Heritage Provider Network Senior |
$13.49
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.29
|
| Rate for Payer: Multiplan Commercial |
$21.86
|
| Rate for Payer: Multiplan Commercial |
$42.65
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.53
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.83
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.65
|
|
|
METHYLPREDNISOLONE 8 MG TABLET [10576]
|
Facility
|
OP
|
$1.93
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.24 |
| Max. Negotiated Rate |
$1.64 |
| Rate for Payer: Adventist Health Commercial |
$0.39
|
| Rate for Payer: Adventist Health Commercial |
$0.35
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.92
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.33
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.19
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.64
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.47
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.80
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.31
|
| Rate for Payer: Cash Price |
$1.06
|
| Rate for Payer: Cash Price |
$0.95
|
| Rate for Payer: Cash Price |
$0.95
|
| Rate for Payer: Cash Price |
$1.06
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.47
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.64
|
| Rate for Payer: Dignity Health Senior |
$1.47
|
| Rate for Payer: Dignity Health Senior |
$1.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.11
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.80
|
| Rate for Payer: Heritage Provider Network Senior |
$0.80
|
| Rate for Payer: Heritage Provider Network Senior |
$0.89
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.92
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.83
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.35
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.31
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.48
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.35
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.35
|
| Rate for Payer: Multiplan Commercial |
$1.45
|
| Rate for Payer: Multiplan Commercial |
$1.30
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.77
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.69
|
| Rate for Payer: TriValley Medical Group Senior |
$0.69
|
| Rate for Payer: TriValley Medical Group Senior |
$0.77
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.70
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.57
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.64
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.47
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1.47
|
| Rate for Payer: Vantage Medical Group Senior |
$1.64
|
|
|
METHYLPREDNISOLONE 8 MG TABLET [10576]
|
Facility
|
IP
|
$1.73
|
|
|
Service Code
|
HCPCS J7509
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.31 |
| Max. Negotiated Rate |
$1.30 |
| Rate for Payer: Adventist Health Commercial |
$0.35
|
| Rate for Payer: Adventist Health Commercial |
$0.39
|
| Rate for Payer: Cash Price |
$1.06
|
| Rate for Payer: Cash Price |
$0.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.89
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.93
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.89
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.80
|
| Rate for Payer: Heritage Provider Network Senior |
$0.80
|
| Rate for Payer: Heritage Provider Network Senior |
$0.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.43
|
| Rate for Payer: Multiplan Commercial |
$1.45
|
| Rate for Payer: Multiplan Commercial |
$1.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.70
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.57
|
|
|
METHYLPREDNISOLONE ACETATE 20 MG/ML SUSPENSION FOR INJECTION [4994]
|
Facility
|
OP
|
$8.53
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$6.40 |
| Rate for Payer: Adventist Health Commercial |
$1.71
|
| Rate for Payer: Aetna of CA Gatekeeper |
$4.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.86
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.47
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.19
|
| Rate for Payer: Cash Price |
$4.69
|
| Rate for Payer: Cash Price |
$4.69
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.13
|
| Rate for Payer: Dignity Health Senior |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.46
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.95
|
| Rate for Payer: Heritage Provider Network Senior |
$3.95
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.54
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.15
|
| Rate for Payer: Multiplan Commercial |
$6.40
|
| Rate for Payer: TriValley Medical Group Commercial |
$3.41
|
| Rate for Payer: TriValley Medical Group Senior |
$3.41
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.82
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Vantage Medical Group Senior |
$0.13
|
|
|
METHYLPREDNISOLONE ACETATE 20 MG/ML SUSPENSION FOR INJECTION [4994]
|
Facility
|
IP
|
$8.53
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.54 |
| Max. Negotiated Rate |
$6.40 |
| Rate for Payer: Adventist Health Commercial |
$1.71
|
| Rate for Payer: Cash Price |
$4.69
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.61
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.95
|
| Rate for Payer: Heritage Provider Network Senior |
$3.95
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.13
|
| Rate for Payer: Multiplan Commercial |
$6.40
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.82
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]
|
Facility
|
IP
|
$13.63
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$10.22 |
| Rate for Payer: Adventist Health Commercial |
$2.73
|
| Rate for Payer: Adventist Health Commercial |
$2.31
|
| Rate for Payer: Adventist Health Commercial |
$2.73
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$6.36
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.27
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.27
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.32
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.36
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.31
|
| Rate for Payer: Heritage Provider Network Senior |
$6.31
|
| Rate for Payer: Heritage Provider Network Senior |
$5.36
|
| Rate for Payer: Heritage Provider Network Senior |
$6.32
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: Multiplan Commercial |
$10.23
|
| Rate for Payer: Multiplan Commercial |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$10.22
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.93
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.92
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.52
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.83
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.51
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]
|
Facility
|
OP
|
$13.64
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$10.23 |
| Rate for Payer: Adventist Health Commercial |
$2.73
|
| Rate for Payer: Adventist Health Commercial |
$2.31
|
| Rate for Payer: Adventist Health Commercial |
$2.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7.29
|
| Rate for Payer: Aetna of CA Gatekeeper |
$6.18
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7.95
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.36
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.47
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.19
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$6.36
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cash Price |
$6.36
|
| Rate for Payer: Cash Price |
$7.50
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.27
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.32
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.13
|
| Rate for Payer: Dignity Health Senior |
$0.13
|
| Rate for Payer: Dignity Health Senior |
$0.13
|
| Rate for Payer: Dignity Health Senior |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.73
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.12
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.12
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.31
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.36
|
| Rate for Payer: Heritage Provider Network Senior |
$6.31
|
| Rate for Payer: Heritage Provider Network Senior |
$6.32
|
| Rate for Payer: Heritage Provider Network Senior |
$5.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6.50
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.47
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.15
|
| Rate for Payer: Multiplan Commercial |
$10.22
|
| Rate for Payer: Multiplan Commercial |
$8.68
|
| Rate for Payer: Multiplan Commercial |
$10.23
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.45
|
| Rate for Payer: TriValley Medical Group Commercial |
$4.63
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.46
|
| Rate for Payer: TriValley Medical Group Senior |
$4.63
|
| Rate for Payer: TriValley Medical Group Senior |
$5.45
|
| Rate for Payer: TriValley Medical Group Senior |
$5.46
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.92
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.93
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.83
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.51
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.52
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Vantage Medical Group Senior |
$0.13
|
| Rate for Payer: Vantage Medical Group Senior |
$0.13
|
| Rate for Payer: Vantage Medical Group Senior |
$0.13
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION [4996]
|
Facility
|
IP
|
$23.66
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.28 |
| Max. Negotiated Rate |
$17.75 |
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Adventist Health Commercial |
$3.92
|
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cash Price |
$10.77
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.88
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.95
|
| Rate for Payer: Heritage Provider Network Senior |
$10.95
|
| Rate for Payer: Heritage Provider Network Senior |
$9.07
|
| Rate for Payer: Heritage Provider Network Senior |
$10.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.89
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.92
|
| Rate for Payer: Multiplan Commercial |
$17.75
|
| Rate for Payer: Multiplan Commercial |
$14.69
|
| Rate for Payer: Multiplan Commercial |
$17.75
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.55
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.84
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.83
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION [4996]
|
Facility
|
OP
|
$23.67
|
|
|
Service Code
|
HCPCS J1010
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$17.75 |
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Adventist Health Commercial |
$3.92
|
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12.65
|
| Rate for Payer: Aetna of CA Gatekeeper |
$10.47
|
| Rate for Payer: Aetna of CA Gatekeeper |
$12.65
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16.25
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.13
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.47
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.47
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California Commercial |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.19
|
| Rate for Payer: Blue Shield of California EPN |
$0.19
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cash Price |
$10.77
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cash Price |
$10.77
|
| Rate for Payer: Cash Price |
$13.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.88
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9.01
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.89
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.15
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.15
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.13
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.13
|
| Rate for Payer: Dignity Health Senior |
$0.13
|
| Rate for Payer: Dignity Health Senior |
$0.13
|
| Rate for Payer: Dignity Health Senior |
$0.13
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.15
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.12
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.12
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.07
|
| Rate for Payer: Heritage Provider Network Senior |
$10.95
|
| Rate for Payer: Heritage Provider Network Senior |
$10.96
|
| Rate for Payer: Heritage Provider Network Senior |
$9.07
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.12
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.12
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.29
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.89
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.15
|
| Rate for Payer: Multiplan Commercial |
$17.75
|
| Rate for Payer: Multiplan Commercial |
$14.69
|
| Rate for Payer: Multiplan Commercial |
$17.75
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.46
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.83
|
| Rate for Payer: TriValley Medical Group Commercial |
$9.47
|
| Rate for Payer: TriValley Medical Group Senior |
$7.83
|
| Rate for Payer: TriValley Medical Group Senior |
$9.46
|
| Rate for Payer: TriValley Medical Group Senior |
$9.47
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.55
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.07
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.55
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.83
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.84
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.15
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.13
|
| Rate for Payer: Vantage Medical Group Senior |
$0.13
|
| Rate for Payer: Vantage Medical Group Senior |
$0.13
|
| Rate for Payer: Vantage Medical Group Senior |
$0.13
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION [10577]
|
Facility
|
OP
|
$52.78
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$39.59 |
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Adventist Health Commercial |
$8.21
|
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Aetna of CA Gatekeeper |
$28.21
|
| Rate for Payer: Aetna of CA Gatekeeper |
$21.95
|
| Rate for Payer: Aetna of CA Gatekeeper |
$26.87
|
| Rate for Payer: Aetna of CA Gatekeeper |
$16.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.90
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.54
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| 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 |
$0.22
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cash Price |
$27.65
|
| Rate for Payer: Cash Price |
$22.59
|
| Rate for Payer: Cash Price |
$27.65
|
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Cash Price |
$22.59
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.28
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.99
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$19.47
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$23.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.08
|
| Rate for Payer: Heritage Provider Network Senior |
$24.44
|
| Rate for Payer: Heritage Provider Network Senior |
$19.01
|
| Rate for Payer: Heritage Provider Network Senior |
$14.08
|
| Rate for Payer: Heritage Provider Network Senior |
$23.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14.51
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.59
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$23.98
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.43
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Multiplan Commercial |
$30.80
|
| Rate for Payer: Multiplan Commercial |
$22.82
|
| Rate for Payer: Multiplan Commercial |
$39.59
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: TriValley Medical Group Commercial |
$12.17
|
| Rate for Payer: TriValley Medical Group Commercial |
$16.42
|
| Rate for Payer: TriValley Medical Group Commercial |
$20.11
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.11
|
| Rate for Payer: TriValley Medical Group Senior |
$12.17
|
| Rate for Payer: TriValley Medical Group Senior |
$16.42
|
| Rate for Payer: TriValley Medical Group Senior |
$21.11
|
| Rate for Payer: TriValley Medical Group Senior |
$20.11
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.99
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.16
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.83
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION [10577]
|
Facility
|
IP
|
$50.27
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.10 |
| Max. Negotiated Rate |
$37.70 |
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Adventist Health Commercial |
$6.08
|
| Rate for Payer: Adventist Health Commercial |
$8.21
|
| Rate for Payer: Cash Price |
$22.59
|
| Rate for Payer: Cash Price |
$27.65
|
| Rate for Payer: Cash Price |
$29.03
|
| Rate for Payer: Cash Price |
$16.73
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23.12
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.28
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.17
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$23.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$14.08
|
| Rate for Payer: Heritage Provider Network Senior |
$24.44
|
| Rate for Payer: Heritage Provider Network Senior |
$14.08
|
| Rate for Payer: Heritage Provider Network Senior |
$19.01
|
| Rate for Payer: Heritage Provider Network Senior |
$23.28
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.43
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.61
|
| Rate for Payer: Multiplan Commercial |
$22.82
|
| Rate for Payer: Multiplan Commercial |
$39.59
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: Multiplan Commercial |
$30.80
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.16
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.83
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.99
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.59
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.64
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$10.07
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION [10578]
|
Facility
|
OP
|
$13.98
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$10.48 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$7.47
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.60
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Cash Price |
$7.69
|
| Rate for Payer: Cash Price |
$7.69
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.95
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.47
|
| Rate for Payer: Heritage Provider Network Senior |
$6.47
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6.67
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.50
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Multiplan Commercial |
$10.48
|
| Rate for Payer: TriValley Medical Group Commercial |
$5.59
|
| Rate for Payer: TriValley Medical Group Senior |
$5.59
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.05
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.63
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION [10578]
|
Facility
|
IP
|
$13.98
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$10.48 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Cash Price |
$7.69
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.47
|
| Rate for Payer: Heritage Provider Network Senior |
$6.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.53
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.50
|
| Rate for Payer: Multiplan Commercial |
$10.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$5.05
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.63
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 2 GRAM INTRAVENOUS SOLUTION [10579]
|
Facility
|
IP
|
$130.63
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$23.64 |
| Max. Negotiated Rate |
$97.97 |
| Rate for Payer: Adventist Health Commercial |
$26.13
|
| Rate for Payer: Cash Price |
$71.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$60.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$70.54
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.48
|
| Rate for Payer: Heritage Provider Network Senior |
$60.48
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.64
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.66
|
| Rate for Payer: Multiplan Commercial |
$97.97
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$47.20
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$43.25
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 2 GRAM INTRAVENOUS SOLUTION [10579]
|
Facility
|
OP
|
$130.63
|
|
|
Service Code
|
HCPCS J2919
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.22 |
| Max. Negotiated Rate |
$97.97 |
| Rate for Payer: Adventist Health Commercial |
$26.13
|
| Rate for Payer: Aetna of CA Gatekeeper |
$69.82
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$89.74
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.28
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.32
|
| Rate for Payer: Blue Shield of California Commercial |
$0.22
|
| Rate for Payer: Blue Shield of California EPN |
$0.22
|
| Rate for Payer: Cash Price |
$71.85
|
| Rate for Payer: Cash Price |
$71.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$60.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.32
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.28
|
| Rate for Payer: Dignity Health Senior |
$0.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$83.60
|
| Rate for Payer: EPIC Health Plan Medicare |
$0.26
|
| Rate for Payer: Heritage Provider Network Commercial |
$60.48
|
| Rate for Payer: Heritage Provider Network Senior |
$60.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$0.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$0.26
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$62.31
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$23.64
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$0.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$32.66
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.33
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.33
|
| Rate for Payer: Multiplan Commercial |
$97.97
|
| Rate for Payer: TriValley Medical Group Commercial |
$52.25
|
| Rate for Payer: TriValley Medical Group Senior |
$52.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$47.20
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$43.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.32
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Vantage Medical Group Senior |
$0.28
|
|
