|
ZIPRASIDONE 20 MG CAPSULE [29778]
|
Facility
|
OP
|
$5.79
|
|
|
Service Code
|
NDC 0904-6269-08
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$4.92 |
| Rate for Payer: Adventist Health Commercial |
$1.16
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.34
|
| Rate for Payer: Blue Shield of California Commercial |
$3.53
|
| Rate for Payer: Blue Shield of California EPN |
$2.83
|
| Rate for Payer: Cash Price |
$3.18
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.92
|
| Rate for Payer: Dignity Health Senior |
$4.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.58
|
| Rate for Payer: Heritage Provider Network Senior |
$3.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.05
|
| Rate for Payer: Multiplan Commercial |
$4.34
|
| Rate for Payer: TriValley Medical Group Commercial |
$2.32
|
| Rate for Payer: TriValley Medical Group Senior |
$2.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.92
|
| Rate for Payer: Vantage Medical Group Senior |
$4.92
|
|
|
ZIPRASIDONE 20 MG CAPSULE [29778]
|
Facility
|
OP
|
$0.60
|
|
|
Service Code
|
NDC 55111-256-60
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.11 |
| Max. Negotiated Rate |
$0.51 |
| Rate for Payer: Adventist Health Commercial |
$0.12
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.32
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.51
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.33
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.45
|
| Rate for Payer: Blue Shield of California Commercial |
$0.37
|
| Rate for Payer: Blue Shield of California EPN |
$0.29
|
| Rate for Payer: Cash Price |
$0.33
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.39
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.51
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.51
|
| Rate for Payer: Dignity Health Senior |
$0.51
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.37
|
| Rate for Payer: Heritage Provider Network Senior |
$0.37
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.29
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.42
|
| Rate for Payer: Multiplan Commercial |
$0.45
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.24
|
| Rate for Payer: TriValley Medical Group Senior |
$0.24
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.30
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.30
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.51
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.51
|
| Rate for Payer: Vantage Medical Group Senior |
$0.51
|
|
|
ZIPRASIDONE 20 MG CAPSULE [29778]
|
Facility
|
IP
|
$0.50
|
|
|
Service Code
|
NDC 65862-702-60
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.38 |
| Rate for Payer: Adventist Health Commercial |
$0.10
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.34
|
| Rate for Payer: Heritage Provider Network Senior |
$0.34
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
| Rate for Payer: Multiplan Commercial |
$0.38
|
|
|
ZIPRASIDONE 20 MG CAPSULE [29778]
|
Facility
|
OP
|
$0.50
|
|
|
Service Code
|
NDC 65862-702-60
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.09 |
| Max. Negotiated Rate |
$0.43 |
| Rate for Payer: Adventist Health Commercial |
$0.10
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.27
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.34
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.43
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.28
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.38
|
| Rate for Payer: Blue Shield of California Commercial |
$0.31
|
| Rate for Payer: Blue Shield of California EPN |
$0.24
|
| Rate for Payer: Cash Price |
$0.28
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.33
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.43
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.43
|
| Rate for Payer: Dignity Health Senior |
$0.43
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.31
|
| Rate for Payer: Heritage Provider Network Senior |
$0.31
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.09
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.13
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.35
|
| Rate for Payer: Multiplan Commercial |
$0.38
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.20
|
| Rate for Payer: TriValley Medical Group Senior |
$0.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.25
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.25
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.43
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.43
|
| Rate for Payer: Vantage Medical Group Senior |
$0.43
|
|
|
ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION [33175]
|
Facility
|
IP
|
$56.40
|
|
|
Service Code
|
HCPCS J3486
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$10.21 |
| Max. Negotiated Rate |
$42.30 |
| Rate for Payer: Adventist Health Commercial |
$11.28
|
| Rate for Payer: Cash Price |
$31.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$30.46
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.11
|
| Rate for Payer: Heritage Provider Network Senior |
$26.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.10
|
| Rate for Payer: Multiplan Commercial |
$42.30
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.67
|
|
|
ZIPRASIDONE 20 MG/ML (FINAL CONCENTRATION) INTRAMUSCULAR SOLUTION [33175]
|
Facility
|
OP
|
$56.40
|
|
|
Service Code
|
HCPCS J3486
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$5.18 |
| Max. Negotiated Rate |
$47.94 |
| Rate for Payer: Adventist Health Commercial |
$11.28
|
| Rate for Payer: Aetna of CA Gatekeeper |
$30.15
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$38.75
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$47.94
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$31.02
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$42.30
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$42.41
|
| Rate for Payer: Blue Shield of California Commercial |
$16.70
|
| Rate for Payer: Blue Shield of California EPN |
$16.70
|
| Rate for Payer: Cash Price |
$31.02
|
| Rate for Payer: Cash Price |
$31.02
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.94
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$47.94
|
| Rate for Payer: Dignity Health Medi-Cal |
$47.94
|
| Rate for Payer: Dignity Health Senior |
$47.94
|
| Rate for Payer: EPIC Health Plan Commercial |
$36.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.11
|
| Rate for Payer: Heritage Provider Network Senior |
$26.11
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$5.18
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$26.90
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$10.21
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$14.10
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$39.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39.48
|
| Rate for Payer: Multiplan Commercial |
$42.30
|
| Rate for Payer: TriValley Medical Group Commercial |
$22.56
|
| Rate for Payer: TriValley Medical Group Senior |
$22.56
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$20.38
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$18.67
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$47.94
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$47.94
|
| Rate for Payer: Vantage Medical Group Senior |
$47.94
|
|
|
ZIPRASIDONE 40 MG CAPSULE [29779]
|
Facility
|
OP
|
$5.79
|
|
|
Service Code
|
NDC 0904-6270-08
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$4.92 |
| Rate for Payer: Adventist Health Commercial |
$1.16
|
| Rate for Payer: Aetna of CA Gatekeeper |
$3.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3.98
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$4.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$3.18
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$4.34
|
| Rate for Payer: Blue Shield of California Commercial |
$3.53
|
| Rate for Payer: Blue Shield of California EPN |
$2.83
|
| Rate for Payer: Cash Price |
$3.18
|
| Rate for Payer: Cigna of CA HMO/PPO |
$3.76
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$4.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$4.92
|
| Rate for Payer: Dignity Health Senior |
$4.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.71
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.58
|
| Rate for Payer: Heritage Provider Network Senior |
$3.58
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$2.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$4.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$4.05
|
| Rate for Payer: Multiplan Commercial |
$4.34
|
| Rate for Payer: TriValley Medical Group Commercial |
$2.32
|
| Rate for Payer: TriValley Medical Group Senior |
$2.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$2.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$2.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$4.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$4.92
|
| Rate for Payer: Vantage Medical Group Senior |
$4.92
|
|
|
ZIPRASIDONE 40 MG CAPSULE [29779]
|
Facility
|
IP
|
$1.60
|
|
|
Service Code
|
NDC 60505-2529-6
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.29 |
| Max. Negotiated Rate |
$1.20 |
| Rate for Payer: Adventist Health Commercial |
$0.32
|
| Rate for Payer: Cash Price |
$0.88
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.86
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.08
|
| Rate for Payer: Heritage Provider Network Senior |
$1.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.40
|
| Rate for Payer: Multiplan Commercial |
$1.20
|
|
|
ZIPRASIDONE 40 MG CAPSULE [29779]
|
Facility
|
IP
|
$5.79
|
|
|
Service Code
|
NDC 0904-6270-08
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$1.05 |
| Max. Negotiated Rate |
$4.34 |
| Rate for Payer: Adventist Health Commercial |
$1.16
|
| Rate for Payer: Cash Price |
$3.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$3.13
|
| Rate for Payer: Heritage Provider Network Commercial |
$3.92
|
| Rate for Payer: Heritage Provider Network Senior |
$3.92
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$1.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1.45
|
| Rate for Payer: Multiplan Commercial |
$4.34
|
|
|
ZIPRASIDONE 40 MG CAPSULE [29779]
|
Facility
|
OP
|
$1.60
|
|
|
Service Code
|
NDC 60505-2529-6
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.29 |
| Max. Negotiated Rate |
$1.36 |
| Rate for Payer: Adventist Health Commercial |
$0.32
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.86
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.36
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.88
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.20
|
| Rate for Payer: Blue Shield of California Commercial |
$0.98
|
| Rate for Payer: Blue Shield of California EPN |
$0.78
|
| Rate for Payer: Cash Price |
$0.88
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.36
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.36
|
| Rate for Payer: Dignity Health Senior |
$1.36
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.99
|
| Rate for Payer: Heritage Provider Network Senior |
$0.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.40
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.12
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.12
|
| Rate for Payer: Multiplan Commercial |
$1.20
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.64
|
| Rate for Payer: TriValley Medical Group Senior |
$0.64
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.80
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.80
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.36
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.36
|
| Rate for Payer: Vantage Medical Group Senior |
$1.36
|
|
|
ZIPRASIDONE 60 MG CAPSULE [29780]
|
Facility
|
IP
|
$0.70
|
|
|
Service Code
|
NDC 55111-258-60
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$0.53 |
| Rate for Payer: Adventist Health Commercial |
$0.14
|
| Rate for Payer: Cash Price |
$0.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.47
|
| Rate for Payer: Heritage Provider Network Senior |
$0.47
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.18
|
| Rate for Payer: Multiplan Commercial |
$0.53
|
|
|
ZIPRASIDONE 60 MG CAPSULE [29780]
|
Facility
|
IP
|
$1.12
|
|
|
Service Code
|
NDC 68001-452-06
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.84 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.60
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.76
|
| Rate for Payer: Heritage Provider Network Senior |
$0.76
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Multiplan Commercial |
$0.84
|
|
|
ZIPRASIDONE 60 MG CAPSULE [29780]
|
Facility
|
OP
|
$0.70
|
|
|
Service Code
|
NDC 55111-258-60
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.13 |
| Max. Negotiated Rate |
$0.60 |
| Rate for Payer: Adventist Health Commercial |
$0.14
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.37
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.60
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.39
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.53
|
| Rate for Payer: Blue Shield of California Commercial |
$0.43
|
| Rate for Payer: Blue Shield of California EPN |
$0.34
|
| Rate for Payer: Cash Price |
$0.38
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.46
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.60
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.60
|
| Rate for Payer: Dignity Health Senior |
$0.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.43
|
| Rate for Payer: Heritage Provider Network Senior |
$0.43
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.33
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.13
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.18
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.49
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.49
|
| Rate for Payer: Multiplan Commercial |
$0.53
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.28
|
| Rate for Payer: TriValley Medical Group Senior |
$0.28
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.35
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.35
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.60
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.60
|
| Rate for Payer: Vantage Medical Group Senior |
$0.60
|
|
|
ZIPRASIDONE 60 MG CAPSULE [29780]
|
Facility
|
OP
|
$1.12
|
|
|
Service Code
|
NDC 68001-452-06
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.95 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.60
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.77
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.62
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.84
|
| Rate for Payer: Blue Shield of California Commercial |
$0.68
|
| Rate for Payer: Blue Shield of California EPN |
$0.55
|
| Rate for Payer: Cash Price |
$0.62
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.73
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.95
|
| Rate for Payer: Dignity Health Senior |
$0.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.72
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.69
|
| Rate for Payer: Heritage Provider Network Senior |
$0.69
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.53
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.28
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.78
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.78
|
| Rate for Payer: Multiplan Commercial |
$0.84
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.45
|
| Rate for Payer: TriValley Medical Group Senior |
$0.45
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.56
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.95
|
| Rate for Payer: Vantage Medical Group Senior |
$0.95
|
|
|
ZIPRASIDONE 80 MG CAPSULE [29781]
|
Facility
|
OP
|
$1.80
|
|
|
Service Code
|
NDC 60505-2531-6
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$1.53 |
| Rate for Payer: Adventist Health Commercial |
$0.36
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.96
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.24
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.53
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.99
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.35
|
| Rate for Payer: Blue Shield of California Commercial |
$1.10
|
| Rate for Payer: Blue Shield of California EPN |
$0.88
|
| Rate for Payer: Cash Price |
$0.99
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.17
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.53
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.53
|
| Rate for Payer: Dignity Health Senior |
$1.53
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.15
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.11
|
| Rate for Payer: Heritage Provider Network Senior |
$1.11
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.86
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.45
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.26
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.26
|
| Rate for Payer: Multiplan Commercial |
$1.35
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.72
|
| Rate for Payer: TriValley Medical Group Senior |
$0.72
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.90
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.90
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.53
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.53
|
| Rate for Payer: Vantage Medical Group Senior |
$1.53
|
|
|
ZIPRASIDONE 80 MG CAPSULE [29781]
|
Facility
|
IP
|
$3.32
|
|
|
Service Code
|
NDC 68084-106-11
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$2.49 |
| Rate for Payer: Adventist Health Commercial |
$0.66
|
| Rate for Payer: Cash Price |
$1.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.25
|
| Rate for Payer: Heritage Provider Network Senior |
$2.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.83
|
| Rate for Payer: Multiplan Commercial |
$2.49
|
|
|
ZIPRASIDONE 80 MG CAPSULE [29781]
|
Facility
|
OP
|
$3.32
|
|
|
Service Code
|
NDC 68084-106-09
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$2.82 |
| Rate for Payer: Adventist Health Commercial |
$0.66
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.77
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.49
|
| Rate for Payer: Blue Shield of California Commercial |
$2.03
|
| Rate for Payer: Blue Shield of California EPN |
$1.62
|
| Rate for Payer: Cash Price |
$1.83
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.82
|
| Rate for Payer: Dignity Health Senior |
$2.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.06
|
| Rate for Payer: Heritage Provider Network Senior |
$2.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.32
|
| Rate for Payer: Multiplan Commercial |
$2.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$1.33
|
| Rate for Payer: TriValley Medical Group Senior |
$1.33
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.82
|
| Rate for Payer: Vantage Medical Group Senior |
$2.82
|
|
|
ZIPRASIDONE 80 MG CAPSULE [29781]
|
Facility
|
IP
|
$1.80
|
|
|
Service Code
|
NDC 60505-2531-6
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.33 |
| Max. Negotiated Rate |
$1.35 |
| Rate for Payer: Adventist Health Commercial |
$0.36
|
| Rate for Payer: Cash Price |
$0.99
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.97
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.22
|
| Rate for Payer: Heritage Provider Network Senior |
$1.22
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.33
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.45
|
| Rate for Payer: Multiplan Commercial |
$1.35
|
|
|
ZIPRASIDONE 80 MG CAPSULE [29781]
|
Facility
|
IP
|
$3.32
|
|
|
Service Code
|
NDC 68084-106-09
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$2.49 |
| Rate for Payer: Adventist Health Commercial |
$0.66
|
| Rate for Payer: Cash Price |
$1.83
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.79
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.25
|
| Rate for Payer: Heritage Provider Network Senior |
$2.25
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.83
|
| Rate for Payer: Multiplan Commercial |
$2.49
|
|
|
ZIPRASIDONE 80 MG CAPSULE [29781]
|
Facility
|
OP
|
$3.32
|
|
|
Service Code
|
NDC 68084-106-11
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.60 |
| Max. Negotiated Rate |
$2.82 |
| Rate for Payer: Adventist Health Commercial |
$0.66
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.77
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$2.28
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$2.82
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.83
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$2.49
|
| Rate for Payer: Blue Shield of California Commercial |
$2.03
|
| Rate for Payer: Blue Shield of California EPN |
$1.62
|
| Rate for Payer: Cash Price |
$1.83
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2.16
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$2.82
|
| Rate for Payer: Dignity Health Medi-Cal |
$2.82
|
| Rate for Payer: Dignity Health Senior |
$2.82
|
| Rate for Payer: EPIC Health Plan Commercial |
$2.12
|
| Rate for Payer: Heritage Provider Network Commercial |
$2.06
|
| Rate for Payer: Heritage Provider Network Senior |
$2.06
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1.58
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.60
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.83
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$2.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$2.32
|
| Rate for Payer: Multiplan Commercial |
$2.49
|
| Rate for Payer: TriValley Medical Group Commercial |
$1.33
|
| Rate for Payer: TriValley Medical Group Senior |
$1.33
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1.66
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1.66
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$2.82
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$2.82
|
| Rate for Payer: Vantage Medical Group Senior |
$2.82
|
|
|
ZIV-AFLIBERCEPT 100 MG/4 ML (25 MG/ML) INTRAVENOUS SOLUTION [197072]
|
Facility
|
IP
|
$480.00
|
|
|
Service Code
|
HCPCS J9400
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Adventist Health Commercial |
$96.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$220.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$259.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$222.24
|
| Rate for Payer: Heritage Provider Network Senior |
$222.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.00
|
| Rate for Payer: Multiplan Commercial |
$360.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$173.42
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$158.93
|
|
|
ZIV-AFLIBERCEPT 100 MG/4 ML (25 MG/ML) INTRAVENOUS SOLUTION [197072]
|
Facility
|
OP
|
$480.00
|
|
|
Service Code
|
HCPCS J9400
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.98 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Adventist Health Commercial |
$96.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$256.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$329.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.44
|
| Rate for Payer: Blue Shield of California Commercial |
$16.32
|
| Rate for Payer: Blue Shield of California EPN |
$16.32
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$220.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.78
|
| Rate for Payer: Dignity Health Senior |
$8.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$307.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$222.24
|
| Rate for Payer: Heritage Provider Network Senior |
$222.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$228.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.05
|
| Rate for Payer: Multiplan Commercial |
$360.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$192.00
|
| Rate for Payer: TriValley Medical Group Senior |
$192.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$173.42
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$158.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.78
|
| Rate for Payer: Vantage Medical Group Senior |
$8.78
|
|
|
ZIV-AFLIBERCEPT 200 MG/8 ML (25 MG/ML) INTRAVENOUS SOLUTION [197073]
|
Facility
|
OP
|
$480.00
|
|
|
Service Code
|
HCPCS J9400
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$7.98 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Adventist Health Commercial |
$96.00
|
| Rate for Payer: Aetna of CA Gatekeeper |
$256.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$329.76
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$11.97
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$8.78
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$8.78
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$41.44
|
| Rate for Payer: Blue Shield of California Commercial |
$16.32
|
| Rate for Payer: Blue Shield of California EPN |
$16.32
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$220.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$9.97
|
| Rate for Payer: Dignity Health Medi-Cal |
$8.78
|
| Rate for Payer: Dignity Health Senior |
$8.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$307.20
|
| Rate for Payer: EPIC Health Plan Medicare |
$7.98
|
| Rate for Payer: Heritage Provider Network Commercial |
$222.24
|
| Rate for Payer: Heritage Provider Network Senior |
$222.24
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$8.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$7.98
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$228.96
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$9.18
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$10.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$10.05
|
| Rate for Payer: Multiplan Commercial |
$360.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$192.00
|
| Rate for Payer: TriValley Medical Group Senior |
$192.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$173.42
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$158.93
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$9.97
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$8.78
|
| Rate for Payer: Vantage Medical Group Senior |
$8.78
|
|
|
ZIV-AFLIBERCEPT 200 MG/8 ML (25 MG/ML) INTRAVENOUS SOLUTION [197073]
|
Facility
|
IP
|
$480.00
|
|
|
Service Code
|
HCPCS J9400
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$86.88 |
| Max. Negotiated Rate |
$360.00 |
| Rate for Payer: Adventist Health Commercial |
$96.00
|
| Rate for Payer: Cash Price |
$264.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$220.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$259.20
|
| Rate for Payer: Heritage Provider Network Commercial |
$222.24
|
| Rate for Payer: Heritage Provider Network Senior |
$222.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$86.88
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$120.00
|
| Rate for Payer: Multiplan Commercial |
$360.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$173.42
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$158.93
|
|
|
ZOLEDRONIC ACID 4 MG/100 ML-MANNITOL-0.9 % NACL INTRAVENOUS PIGGYBACK [201638]
|
Facility
|
OP
|
$2.16
|
|
|
Service Code
|
HCPCS J3489
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$0.39 |
| Max. Negotiated Rate |
$57.50 |
| Rate for Payer: Adventist Health Commercial |
$0.43
|
| Rate for Payer: Aetna of CA Gatekeeper |
$1.15
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.48
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.84
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$1.19
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.62
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$57.50
|
| Rate for Payer: Blue Shield of California Commercial |
$20.40
|
| Rate for Payer: Blue Shield of California EPN |
$20.40
|
| Rate for Payer: Cash Price |
$1.19
|
| Rate for Payer: Cash Price |
$1.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.99
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.84
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.84
|
| Rate for Payer: Dignity Health Senior |
$1.84
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.38
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.00
|
| Rate for Payer: Heritage Provider Network Senior |
$1.00
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$9.52
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$1.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.39
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.54
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$1.51
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$1.51
|
| Rate for Payer: Multiplan Commercial |
$1.62
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.86
|
| Rate for Payer: TriValley Medical Group Senior |
$0.86
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.78
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.72
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.84
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.84
|
| Rate for Payer: Vantage Medical Group Senior |
$1.84
|
|
