|
METHYLPREDNISOLONE 500 MG INJ WRAP FOR CNR USE ONLY [4081203]
|
Facility
IP
|
$29.14
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
ERX4081203
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.27 |
| Max. Negotiated Rate |
$21.86 |
| Rate for Payer: Adventist Health Commercial |
$5.83
|
| Rate for Payer: Adventist Health Commercial |
$10.63
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36.51
|
| Rate for Payer: Cash Price |
$23.91
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.44
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.40
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.74
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.70
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$35.98
|
| Rate for Payer: Heritage Provider Network Senior |
$35.98
|
| Rate for Payer: Heritage Provider Network Senior |
$19.73
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.62
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: Multiplan Commercial |
$39.86
|
| Rate for Payer: Multiplan Commercial |
$21.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.75
|
|
|
METHYLPREDNISOLONE 500 MG INJ WRAP FOR CNR USE ONLY [4081203]
|
Facility
OP
|
$29.14
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
ERX4081203
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.27 |
| Max. Negotiated Rate |
$24.77 |
| Rate for Payer: Adventist Health Commercial |
$5.83
|
| Rate for Payer: Adventist Health Commercial |
$10.63
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.45
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36.51
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$45.17
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$29.23
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.86
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$39.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.53
|
| Rate for Payer: Blue Shield of California Commercial |
$7.01
|
| Rate for Payer: Blue Shield of California Commercial |
$7.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$23.91
|
| Rate for Payer: Cash Price |
$23.91
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$45.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.77
|
| Rate for Payer: Dignity Health Medi-Cal |
$45.17
|
| Rate for Payer: Dignity Health Senior |
$24.77
|
| Rate for Payer: Dignity Health Senior |
$45.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.49
|
| Rate for Payer: Heritage Provider Network Senior |
$13.49
|
| Rate for Payer: Heritage Provider Network Senior |
$24.60
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.61
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.62
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.27
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.28
|
| Rate for Payer: Multiplan Commercial |
$21.86
|
| Rate for Payer: Multiplan Commercial |
$39.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.37
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.62
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.75
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.74
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$45.17
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.77
|
| Rate for Payer: Vantage Medical Group Senior |
$45.17
|
| Rate for Payer: Vantage Medical Group Senior |
$24.77
|
|
|
METHYLPREDNISOLONE 8 MG TABLET [10576]
|
Facility
IP
|
$1.93
|
|
|
Service Code
|
CPT J7509
|
| Hospital Charge Code |
1710983
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.35 |
| Max. Negotiated Rate |
$1.45 |
| Rate for Payer: Adventist Health Commercial |
$0.39
|
| Rate for Payer: Adventist Health Commercial |
$0.35
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.33
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cash Price |
$0.87
|
| 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 |
$1.31
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.17
|
| Rate for Payer: Heritage Provider Network Senior |
$1.31
|
| Rate for Payer: Heritage Provider Network Senior |
$1.17
|
| 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 |
$0.48
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.43
|
| Rate for Payer: Multiplan Commercial |
$1.30
|
| Rate for Payer: Multiplan Commercial |
$1.45
|
| 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+ |
$0.58
|
|
|
METHYLPREDNISOLONE 8 MG TABLET [10576]
|
Facility
OP
|
$1.93
|
|
|
Service Code
|
CPT J7509
|
| Hospital Charge Code |
1710983
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.31 |
| 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 |
$0.56
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.19
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.33
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.64
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$1.47
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$1.06
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.30
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$1.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.83
|
| 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 |
$0.87
|
| Rate for Payer: Cash Price |
$0.87
|
| Rate for Payer: Cash Price |
$0.78
|
| Rate for Payer: Cash Price |
$0.78
|
| 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 |
$1.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.47
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.47
|
| 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 |
$0.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.89
|
| 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 Commercial |
$0.93
|
| 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 |
$0.48
|
| 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+ |
$0.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.47
|
| Rate for Payer: Vantage Medical Group Senior |
$1.64
|
| Rate for Payer: Vantage Medical Group Senior |
$1.47
|
|
|
METHYLPREDNISOLONE ACETATE 20 MG/ML SUSPENSION FOR INJECTION [4994]
|
Facility
OP
|
$8.53
|
|
|
Service Code
|
CPT J1020
|
| Hospital Charge Code |
NDG4994
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.54 |
| Max. Negotiated Rate |
$17.29 |
| Rate for Payer: Adventist Health Commercial |
$1.71
|
| Rate for Payer: Aetna of CA Gatekeeper |
$17.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.25
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.40
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.85
|
| Rate for Payer: Blue Shield of California Commercial |
$4.05
|
| Rate for Payer: Blue Shield of California EPN |
$4.05
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Cash Price |
$3.84
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.25
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.25
|
| Rate for Payer: Dignity Health Senior |
$7.25
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.46
|
| 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 Commercial |
$4.11
|
| 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 |
$3.11
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.85
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.25
|
| Rate for Payer: Vantage Medical Group Senior |
$7.25
|
|
|
METHYLPREDNISOLONE ACETATE 20 MG/ML SUSPENSION FOR INJECTION [4994]
|
Facility
IP
|
$8.53
|
|
|
Service Code
|
CPT J1020
|
| Hospital Charge Code |
NDG4994
|
|
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: Aetna of CA Non-Gatekeeper |
$5.86
|
| Rate for Payer: Cash Price |
$3.84
|
| 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 |
$5.77
|
| Rate for Payer: Heritage Provider Network Senior |
$5.77
|
| 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 |
$3.11
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.85
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]
|
Facility
OP
|
$13.64
|
|
|
Service Code
|
CPT J1030
|
| Hospital Charge Code |
1720218
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.47 |
| Max. Negotiated Rate |
$15.76 |
| Rate for Payer: Adventist Health Commercial |
$2.73
|
| Rate for Payer: Adventist Health Commercial |
$2.09
|
| Rate for Payer: Adventist Health Commercial |
$2.73
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.76
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.76
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.76
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7.17
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$8.87
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.59
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.50
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$5.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.23
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$7.83
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.22
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.25
|
| Rate for Payer: Blue Shield of California Commercial |
$8.18
|
| Rate for Payer: Blue Shield of California Commercial |
$8.18
|
| Rate for Payer: Blue Shield of California Commercial |
$8.18
|
| Rate for Payer: Blue Shield of California EPN |
$8.18
|
| Rate for Payer: Blue Shield of California EPN |
$8.18
|
| Rate for Payer: Blue Shield of California EPN |
$8.18
|
| Rate for Payer: Cash Price |
$4.70
|
| Rate for Payer: Cash Price |
$4.70
|
| Rate for Payer: Cash Price |
$6.14
|
| Rate for Payer: Cash Price |
$6.14
|
| Rate for Payer: Cash Price |
$6.13
|
| Rate for Payer: Cash Price |
$6.13
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.27
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.27
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$8.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.87
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.59
|
| Rate for Payer: Dignity Health Senior |
$8.87
|
| Rate for Payer: Dignity Health Senior |
$11.59
|
| Rate for Payer: Dignity Health Senior |
$11.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.72
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.73
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.68
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.83
|
| Rate for Payer: Heritage Provider Network Commercial |
$6.32
|
| 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 |
$6.32
|
| Rate for Payer: Heritage Provider Network Senior |
$4.83
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5.03
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6.57
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$6.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.89
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: Multiplan Commercial |
$10.22
|
| Rate for Payer: Multiplan Commercial |
$10.23
|
| Rate for Payer: Multiplan Commercial |
$7.83
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.97
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.97
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.55
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.56
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.59
|
| Rate for Payer: Vantage Medical Group Senior |
$11.59
|
| Rate for Payer: Vantage Medical Group Senior |
$8.87
|
| Rate for Payer: Vantage Medical Group Senior |
$11.59
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]
|
Facility
IP
|
$13.63
|
|
|
Service Code
|
CPT J1030
|
| Hospital Charge Code |
1720218
|
|
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 |
$2.73
|
| Rate for Payer: Adventist Health Commercial |
$2.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$7.17
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.36
|
| Rate for Payer: Cash Price |
$6.14
|
| Rate for Payer: Cash Price |
$4.70
|
| Rate for Payer: Cash Price |
$6.13
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4.80
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.27
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.64
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.37
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.23
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.23
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.07
|
| Rate for Payer: Heritage Provider Network Senior |
$9.23
|
| Rate for Payer: Heritage Provider Network Senior |
$9.23
|
| Rate for Payer: Heritage Provider Network Senior |
$7.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.89
|
| 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 |
$3.41
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$3.41
|
| Rate for Payer: Multiplan Commercial |
$10.22
|
| Rate for Payer: Multiplan Commercial |
$7.83
|
| Rate for Payer: Multiplan Commercial |
$10.23
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.97
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3.81
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.97
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.49
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.55
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]
|
Facility
OP
|
$11.83
|
|
|
Service Code
|
CPT J1030
|
| Hospital Charge Code |
1720226
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$15.76 |
| Rate for Payer: Adventist Health Commercial |
$2.37
|
| Rate for Payer: Adventist Health Commercial |
$1.72
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.76
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.76
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.89
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$7.29
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.72
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$6.44
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.25
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.25
|
| Rate for Payer: Blue Shield of California Commercial |
$8.18
|
| Rate for Payer: Blue Shield of California Commercial |
$8.18
|
| Rate for Payer: Blue Shield of California EPN |
$8.18
|
| Rate for Payer: Blue Shield of California EPN |
$8.18
|
| Rate for Payer: Cash Price |
$5.32
|
| Rate for Payer: Cash Price |
$3.86
|
| Rate for Payer: Cash Price |
$3.86
|
| Rate for Payer: Cash Price |
$5.32
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.06
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$7.29
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$7.29
|
| Rate for Payer: Dignity Health Senior |
$10.06
|
| Rate for Payer: Dignity Health Senior |
$7.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$5.49
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.97
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.48
|
| Rate for Payer: Heritage Provider Network Senior |
$5.48
|
| Rate for Payer: Heritage Provider Network Senior |
$3.97
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$4.14
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5.70
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.96
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.14
|
| Rate for Payer: Multiplan Commercial |
$8.87
|
| Rate for Payer: Multiplan Commercial |
$6.44
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.87
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$7.29
|
| Rate for Payer: Vantage Medical Group Senior |
$7.29
|
| Rate for Payer: Vantage Medical Group Senior |
$10.06
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]
|
Facility
IP
|
$8.58
|
|
|
Service Code
|
CPT J1030
|
| Hospital Charge Code |
1720226
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.55 |
| Max. Negotiated Rate |
$6.44 |
| Rate for Payer: Adventist Health Commercial |
$1.72
|
| Rate for Payer: Adventist Health Commercial |
$2.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.89
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.13
|
| Rate for Payer: Cash Price |
$5.32
|
| Rate for Payer: Cash Price |
$3.86
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.95
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.81
|
| Rate for Payer: Heritage Provider Network Senior |
$8.01
|
| Rate for Payer: Heritage Provider Network Senior |
$5.81
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.96
|
| Rate for Payer: Multiplan Commercial |
$8.87
|
| Rate for Payer: Multiplan Commercial |
$6.44
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3.13
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.31
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.95
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.87
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]
|
Facility
IP
|
$11.84
|
|
|
Service Code
|
CPT J1030
|
| Hospital Charge Code |
NDG4995
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$8.88 |
| Rate for Payer: Adventist Health Commercial |
$2.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.13
|
| Rate for Payer: Cash Price |
$5.33
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$6.39
|
| Rate for Payer: Heritage Provider Network Commercial |
$8.02
|
| Rate for Payer: Heritage Provider Network Senior |
$8.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.96
|
| Rate for Payer: Multiplan Commercial |
$8.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.32
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.96
|
|
|
METHYLPREDNISOLONE ACETATE 40 MG/ML SUSPENSION FOR INJECTION [4995]
|
Facility
OP
|
$11.84
|
|
|
Service Code
|
CPT J1030
|
| Hospital Charge Code |
NDG4995
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.14 |
| Max. Negotiated Rate |
$15.76 |
| Rate for Payer: Adventist Health Commercial |
$2.37
|
| Rate for Payer: Aetna of CA Gatekeeper |
$15.76
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$8.13
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$10.06
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$6.51
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$8.88
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.25
|
| Rate for Payer: Blue Shield of California Commercial |
$8.18
|
| Rate for Payer: Blue Shield of California EPN |
$8.18
|
| Rate for Payer: Cash Price |
$5.33
|
| Rate for Payer: Cash Price |
$5.33
|
| Rate for Payer: Cigna of CA HMO/PPO |
$5.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$10.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$10.06
|
| Rate for Payer: Dignity Health Senior |
$10.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$7.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$5.48
|
| Rate for Payer: Heritage Provider Network Senior |
$5.48
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$5.71
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$2.14
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2.96
|
| Rate for Payer: Multiplan Commercial |
$8.88
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$4.32
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3.96
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$10.06
|
| Rate for Payer: Vantage Medical Group Senior |
$10.06
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION [4996]
|
Facility
OP
|
$19.58
|
|
|
Service Code
|
CPT J1040
|
| Hospital Charge Code |
1720010
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.54 |
| Max. Negotiated Rate |
$24.08 |
| Rate for Payer: Adventist Health Commercial |
$3.92
|
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Adventist Health Commercial |
$3.43
|
| Rate for Payer: Aetna of CA Gatekeeper |
$24.08
|
| Rate for Payer: Aetna of CA Gatekeeper |
$24.08
|
| Rate for Payer: Aetna of CA Gatekeeper |
$24.08
|
| Rate for Payer: Aetna of CA Gatekeeper |
$24.08
|
| 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: Aetna of CA Non-Gatekeeper |
$11.79
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.12
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$14.59
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$20.11
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$16.64
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.01
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$13.02
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$9.44
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$10.77
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$12.87
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.74
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$14.68
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$17.75
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.90
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$16.90
|
| Rate for Payer: Blue Shield of California Commercial |
$14.59
|
| Rate for Payer: Blue Shield of California Commercial |
$14.59
|
| Rate for Payer: Blue Shield of California Commercial |
$14.59
|
| Rate for Payer: Blue Shield of California Commercial |
$14.59
|
| Rate for Payer: Blue Shield of California EPN |
$14.59
|
| Rate for Payer: Blue Shield of California EPN |
$14.59
|
| Rate for Payer: Blue Shield of California EPN |
$14.59
|
| Rate for Payer: Blue Shield of California EPN |
$14.59
|
| Rate for Payer: Cash Price |
$8.81
|
| Rate for Payer: Cash Price |
$7.72
|
| Rate for Payer: Cash Price |
$7.72
|
| Rate for Payer: Cash Price |
$8.81
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$10.65
|
| 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 |
$7.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$14.59
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$16.64
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$20.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$20.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$16.64
|
| Rate for Payer: Dignity Health Medi-Cal |
$14.59
|
| Rate for Payer: Dignity Health Senior |
$20.12
|
| Rate for Payer: Dignity Health Senior |
$16.64
|
| Rate for Payer: Dignity Health Senior |
$14.59
|
| Rate for Payer: Dignity Health Senior |
$20.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.15
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.14
|
| Rate for Payer: Heritage Provider Network Commercial |
$7.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.96
|
| Rate for Payer: Heritage Provider Network Commercial |
$9.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$10.95
|
| Rate for Payer: Heritage Provider Network Senior |
$7.95
|
| Rate for Payer: Heritage Provider Network Senior |
$10.96
|
| Rate for Payer: Heritage Provider Network Senior |
$10.95
|
| Rate for Payer: Heritage Provider Network Senior |
$9.07
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.40
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$9.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$8.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$11.41
|
| 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: Kaiser Permanente of CA Medi-Cal |
$3.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$3.54
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$5.92
|
| Rate for Payer: Multiplan Commercial |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$12.87
|
| Rate for Payer: Multiplan Commercial |
$17.75
|
| Rate for Payer: Multiplan Commercial |
$14.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.73
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.91
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.54
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$14.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$16.64
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$20.12
|
| Rate for Payer: Vantage Medical Group Senior |
$16.64
|
| Rate for Payer: Vantage Medical Group Senior |
$14.59
|
| Rate for Payer: Vantage Medical Group Senior |
$20.11
|
| Rate for Payer: Vantage Medical Group Senior |
$20.12
|
|
|
METHYLPREDNISOLONE ACETATE 80 MG/ML SUSPENSION FOR INJECTION [4996]
|
Facility
IP
|
$17.16
|
|
|
Service Code
|
CPT J1040
|
| Hospital Charge Code |
1720010
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$3.11 |
| Max. Negotiated Rate |
$12.87 |
| Rate for Payer: Adventist Health Commercial |
$3.43
|
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Adventist Health Commercial |
$4.73
|
| Rate for Payer: Adventist Health Commercial |
$3.92
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.79
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$13.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$16.25
|
| Rate for Payer: Cash Price |
$7.72
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cash Price |
$8.81
|
| Rate for Payer: Cash Price |
$10.65
|
| Rate for Payer: Cigna of CA HMO/PPO |
$9.01
|
| Rate for Payer: Cigna of CA HMO/PPO |
$7.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$10.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$10.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$9.27
|
| Rate for Payer: EPIC Health Plan Commercial |
$12.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$16.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.26
|
| Rate for Payer: Heritage Provider Network Senior |
$13.26
|
| Rate for Payer: Heritage Provider Network Senior |
$11.62
|
| Rate for Payer: Heritage Provider Network Senior |
$16.02
|
| Rate for Payer: Heritage Provider Network Senior |
$16.02
|
| 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 |
$3.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.28
|
| 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 |
$4.90
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.29
|
| Rate for Payer: Multiplan Commercial |
$17.75
|
| Rate for Payer: Multiplan Commercial |
$17.74
|
| Rate for Payer: Multiplan Commercial |
$12.87
|
| Rate for Payer: Multiplan Commercial |
$14.68
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$7.14
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$6.26
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$8.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$5.73
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$6.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$7.91
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION [10577]
|
Facility
IP
|
$50.27
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
1720344
|
|
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 |
$8.21
|
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.54
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cash Price |
$23.75
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23.12
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.50
|
| Rate for Payer: EPIC Health Plan Commercial |
$22.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$35.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.80
|
| Rate for Payer: Heritage Provider Network Commercial |
$34.03
|
| Rate for Payer: Heritage Provider Network Senior |
$35.73
|
| Rate for Payer: Heritage Provider Network Senior |
$34.03
|
| Rate for Payer: Heritage Provider Network Senior |
$27.80
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.55
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$9.10
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$7.43
|
| 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 |
$10.26
|
| Rate for Payer: Multiplan Commercial |
$30.80
|
| Rate for Payer: Multiplan Commercial |
$39.58
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.97
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.33
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.80
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 1,000 MG INTRAVENOUS SOLUTION [10577]
|
Facility
OP
|
$50.27
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
1720344
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$42.73 |
| Rate for Payer: Adventist Health Commercial |
$10.05
|
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Adventist Health Commercial |
$8.21
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.45
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.45
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$36.26
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.21
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.54
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$44.86
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$42.73
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$34.90
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$29.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$22.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$27.65
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$39.58
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$30.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$37.70
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.53
|
| Rate for Payer: Blue Shield of California Commercial |
$7.01
|
| Rate for Payer: Blue Shield of California Commercial |
$7.01
|
| Rate for Payer: Blue Shield of California Commercial |
$7.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cash Price |
$18.48
|
| Rate for Payer: Cash Price |
$22.62
|
| Rate for Payer: Cash Price |
$23.75
|
| Rate for Payer: Cash Price |
$23.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$18.89
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.28
|
| Rate for Payer: Cigna of CA HMO/PPO |
$23.12
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$34.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$44.86
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$42.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$42.73
|
| Rate for Payer: Dignity Health Medi-Cal |
$34.90
|
| Rate for Payer: Dignity Health Medi-Cal |
$44.86
|
| Rate for Payer: Dignity Health Senior |
$42.73
|
| Rate for Payer: Dignity Health Senior |
$44.86
|
| Rate for Payer: Dignity Health Senior |
$34.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$26.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$32.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.78
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.44
|
| Rate for Payer: Heritage Provider Network Commercial |
$23.28
|
| Rate for Payer: Heritage Provider Network Senior |
$23.28
|
| Rate for Payer: Heritage Provider Network Senior |
$19.01
|
| Rate for Payer: Heritage Provider Network Senior |
$24.44
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$19.79
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$24.23
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$25.44
|
| 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 Medi-Cal |
$9.10
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$12.57
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.26
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$37.70
|
| Rate for Payer: Multiplan Commercial |
$30.80
|
| Rate for Payer: Multiplan Commercial |
$39.58
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$18.33
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.24
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$14.97
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$13.72
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$16.80
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$42.73
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$34.90
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$44.86
|
| Rate for Payer: Vantage Medical Group Senior |
$34.90
|
| Rate for Payer: Vantage Medical Group Senior |
$42.73
|
| Rate for Payer: Vantage Medical Group Senior |
$44.86
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION [10578]
|
Facility
OP
|
$13.98
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
ERX10578
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$2.53 |
| Max. Negotiated Rate |
$14.45 |
| Rate for Payer: Adventist Health Commercial |
$2.80
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$9.60
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$11.88
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$7.69
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$10.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.53
|
| Rate for Payer: Blue Shield of California Commercial |
$7.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cash Price |
$6.29
|
| Rate for Payer: Cigna of CA HMO/PPO |
$6.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$11.88
|
| Rate for Payer: Dignity Health Medi-Cal |
$11.88
|
| Rate for Payer: Dignity Health Senior |
$11.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$8.95
|
| 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 Commercial |
$6.74
|
| 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 |
$5.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.67
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$11.88
|
| Rate for Payer: Vantage Medical Group Senior |
$11.88
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 125 MG SOLUTION FOR INJECTION [10578]
|
Facility
IP
|
$13.98
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
ERX10578
|
|
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: Aetna of CA Non-Gatekeeper |
$9.60
|
| Rate for Payer: Cash Price |
$6.29
|
| 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 |
$9.46
|
| Rate for Payer: Heritage Provider Network Senior |
$9.46
|
| 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 |
$5.10
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$4.67
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 2 GRAM INTRAVENOUS SOLUTION [10579]
|
Facility
OP
|
$113.10
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
ERX10579
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.01 |
| Max. Negotiated Rate |
$96.14 |
| Rate for Payer: Adventist Health Commercial |
$22.62
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$77.70
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$96.14
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$62.20
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$84.82
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.53
|
| Rate for Payer: Blue Shield of California Commercial |
$7.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Cash Price |
$50.90
|
| Rate for Payer: Cash Price |
$50.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$52.03
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$96.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$96.14
|
| Rate for Payer: Dignity Health Senior |
$96.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$72.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.37
|
| Rate for Payer: Heritage Provider Network Senior |
$52.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$54.51
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.28
|
| Rate for Payer: Multiplan Commercial |
$84.82
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$41.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.79
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$96.14
|
| Rate for Payer: Vantage Medical Group Senior |
$96.14
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 2 GRAM INTRAVENOUS SOLUTION [10579]
|
Facility
IP
|
$113.10
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
ERX10579
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$20.47 |
| Max. Negotiated Rate |
$84.82 |
| Rate for Payer: Adventist Health Commercial |
$22.62
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$77.70
|
| Rate for Payer: Cash Price |
$50.90
|
| Rate for Payer: Cigna of CA HMO/PPO |
$52.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$76.57
|
| Rate for Payer: Heritage Provider Network Senior |
$76.57
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$20.47
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$28.28
|
| Rate for Payer: Multiplan Commercial |
$84.82
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$41.24
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$37.79
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION [10580]
|
Facility
OP
|
$7.30
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
ERX10580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.32 |
| Max. Negotiated Rate |
$10.29 |
| Rate for Payer: Adventist Health Commercial |
$1.46
|
| Rate for Payer: Aetna of CA Gatekeeper |
$10.29
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.02
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$6.20
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$4.02
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$5.48
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$4.02
|
| Rate for Payer: Blue Shield of California Commercial |
$5.12
|
| Rate for Payer: Blue Shield of California EPN |
$5.12
|
| Rate for Payer: Cash Price |
$3.29
|
| Rate for Payer: Cash Price |
$3.29
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.36
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$6.20
|
| Rate for Payer: Dignity Health Medi-Cal |
$6.20
|
| Rate for Payer: Dignity Health Senior |
$6.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$4.67
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.38
|
| Rate for Payer: Heritage Provider Network Senior |
$3.38
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$3.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.82
|
| Rate for Payer: Multiplan Commercial |
$5.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.44
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$6.20
|
| Rate for Payer: Vantage Medical Group Senior |
$6.20
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 40 MG SOLUTION FOR INJECTION [10580]
|
Facility
IP
|
$7.30
|
|
|
Service Code
|
CPT J2920
|
| Hospital Charge Code |
ERX10580
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1.32 |
| Max. Negotiated Rate |
$5.48 |
| Rate for Payer: Adventist Health Commercial |
$1.46
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$5.02
|
| Rate for Payer: Cash Price |
$3.29
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.94
|
| Rate for Payer: Heritage Provider Network Commercial |
$4.94
|
| Rate for Payer: Heritage Provider Network Senior |
$4.94
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.32
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.82
|
| Rate for Payer: Multiplan Commercial |
$5.48
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.44
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION [10581]
|
Facility
OP
|
$26.40
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
1720342
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$22.44 |
| Rate for Payer: Adventist Health Commercial |
$5.28
|
| Rate for Payer: Adventist Health Commercial |
$5.55
|
| Rate for Payer: Adventist Health Commercial |
$5.83
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.45
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.45
|
| Rate for Payer: Aetna of CA Gatekeeper |
$14.45
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.02
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18.14
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19.06
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$24.77
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$22.44
|
| Rate for Payer: AlphaCare Medical Group Commercial/Exchange |
$23.58
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$16.03
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$14.52
|
| Rate for Payer: AlphaCare Medical Group Medi-Cal |
$15.26
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$20.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$19.80
|
| Rate for Payer: AlphaCare Medical Group Medicare Advantage/Dual Product |
$21.86
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.53
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$10.53
|
| Rate for Payer: Blue Shield of California Commercial |
$7.01
|
| Rate for Payer: Blue Shield of California Commercial |
$7.01
|
| Rate for Payer: Blue Shield of California Commercial |
$7.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Blue Shield of California EPN |
$7.01
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Cash Price |
$12.48
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Cash Price |
$12.48
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.14
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$24.77
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$22.44
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$23.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$22.44
|
| Rate for Payer: Dignity Health Medi-Cal |
$23.58
|
| Rate for Payer: Dignity Health Medi-Cal |
$24.77
|
| Rate for Payer: Dignity Health Senior |
$24.77
|
| Rate for Payer: Dignity Health Senior |
$23.58
|
| Rate for Payer: Dignity Health Senior |
$22.44
|
| Rate for Payer: EPIC Health Plan Commercial |
$16.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$17.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$18.65
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$12.22
|
| Rate for Payer: Heritage Provider Network Commercial |
$13.49
|
| Rate for Payer: Heritage Provider Network Senior |
$12.22
|
| Rate for Payer: Heritage Provider Network Senior |
$12.84
|
| Rate for Payer: Heritage Provider Network Senior |
$13.49
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$13.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$14.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$12.72
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.60
|
| Rate for Payer: Multiplan Commercial |
$19.80
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Multiplan Commercial |
$21.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.11
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.63
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$24.77
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$23.58
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$22.44
|
| Rate for Payer: Vantage Medical Group Senior |
$23.58
|
| Rate for Payer: Vantage Medical Group Senior |
$22.44
|
| Rate for Payer: Vantage Medical Group Senior |
$24.77
|
|
|
METHYLPREDNISOLONE SODIUM SUCCINATE 500 MG INTRAVENOUS SOLUTION [10581]
|
Facility
IP
|
$26.40
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
1720342
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$4.78 |
| Max. Negotiated Rate |
$19.80 |
| Rate for Payer: Adventist Health Commercial |
$5.28
|
| Rate for Payer: Adventist Health Commercial |
$5.83
|
| Rate for Payer: Adventist Health Commercial |
$5.55
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$18.14
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$19.06
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$20.02
|
| Rate for Payer: Cash Price |
$12.48
|
| Rate for Payer: Cash Price |
$11.88
|
| Rate for Payer: Cash Price |
$13.11
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.76
|
| Rate for Payer: Cigna of CA HMO/PPO |
$13.40
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$14.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$15.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$19.73
|
| Rate for Payer: Heritage Provider Network Commercial |
$17.87
|
| Rate for Payer: Heritage Provider Network Commercial |
$18.78
|
| Rate for Payer: Heritage Provider Network Senior |
$19.73
|
| Rate for Payer: Heritage Provider Network Senior |
$18.78
|
| Rate for Payer: Heritage Provider Network Senior |
$17.87
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.27
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$5.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$4.78
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.94
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$7.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$6.60
|
| Rate for Payer: Multiplan Commercial |
$19.80
|
| Rate for Payer: Multiplan Commercial |
$20.80
|
| Rate for Payer: Multiplan Commercial |
$21.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.11
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.63
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$10.62
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$8.82
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.74
|
|
|
METHYLPREDNISOLONE SOD SUCC (PF) 1,000 MG/8 ML INTRAVENOUS SOLUTION [120963]
|
Facility
IP
|
$77.29
|
|
|
Service Code
|
CPT J2930
|
| Hospital Charge Code |
ERX120963
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$13.99 |
| Max. Negotiated Rate |
$57.97 |
| Rate for Payer: Adventist Health Commercial |
$15.46
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$53.10
|
| Rate for Payer: Cash Price |
$34.78
|
| Rate for Payer: Cigna of CA HMO/PPO |
$35.55
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.74
|
| Rate for Payer: Heritage Provider Network Commercial |
$52.33
|
| Rate for Payer: Heritage Provider Network Senior |
$52.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$13.99
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$19.32
|
| Rate for Payer: Multiplan Commercial |
$57.97
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$28.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$25.82
|
|
