|
ALTEPLASE 100 MG INTRAVENOUS SOLUTION [9002]
|
Facility
|
OP
|
$10,560.43
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$75.89 |
| Max. Negotiated Rate |
$7,920.32 |
| Rate for Payer: Adventist Health Commercial |
$2,112.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,526.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.89
|
| Rate for Payer: Blue Shield of California Commercial |
$89.85
|
| Rate for Payer: Blue Shield of California EPN |
$89.85
|
| Rate for Payer: Cash Price |
$4,752.19
|
| Rate for Payer: Cash Price |
$4,752.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,857.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$123.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,758.68
|
| Rate for Payer: EPIC Health Plan Medicare |
$98.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,889.48
|
| Rate for Payer: Heritage Provider Network Senior |
$4,889.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$98.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$5,037.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,911.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$113.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,640.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$132.11
|
| Rate for Payer: Multiplan Commercial |
$7,920.32
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,224.17
|
| Rate for Payer: TriValley Medical Group Senior |
$4,224.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,815.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,496.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Vantage Medical Group Senior |
$108.45
|
|
|
ALTEPLASE 100 MG INTRAVENOUS SOLUTION (ACUTE THROMBOEMBOLIC STROKE) [4081495]
|
Facility
|
IP
|
$10,560.43
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$1,911.44 |
| Max. Negotiated Rate |
$7,920.32 |
| Rate for Payer: Adventist Health Commercial |
$2,112.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,800.92
|
| Rate for Payer: Cash Price |
$4,752.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,857.80
|
| Rate for Payer: EPIC Health Plan Commercial |
$5,702.63
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,889.48
|
| Rate for Payer: Heritage Provider Network Senior |
$4,889.48
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,911.44
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,640.11
|
| Rate for Payer: Multiplan Commercial |
$7,920.32
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,815.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,496.56
|
|
|
ALTEPLASE 100 MG INTRAVENOUS SOLUTION (ACUTE THROMBOEMBOLIC STROKE) [4081495]
|
Facility
|
OP
|
$10,560.43
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$75.89 |
| Max. Negotiated Rate |
$7,920.32 |
| Rate for Payer: Adventist Health Commercial |
$2,112.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$6,526.35
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.89
|
| Rate for Payer: Blue Shield of California Commercial |
$89.85
|
| Rate for Payer: Blue Shield of California EPN |
$89.85
|
| Rate for Payer: Cash Price |
$4,752.19
|
| Rate for Payer: Cash Price |
$4,752.19
|
| Rate for Payer: Cigna of CA HMO/PPO |
$4,857.80
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$123.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$6,758.68
|
| Rate for Payer: EPIC Health Plan Medicare |
$98.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$4,889.48
|
| Rate for Payer: Heritage Provider Network Senior |
$4,889.48
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$98.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$5,037.33
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$1,911.44
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$113.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$2,640.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$132.11
|
| Rate for Payer: Multiplan Commercial |
$7,920.32
|
| Rate for Payer: TriValley Medical Group Commercial |
$4,224.17
|
| Rate for Payer: TriValley Medical Group Senior |
$4,224.17
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$3,815.48
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$3,496.56
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Vantage Medical Group Senior |
$108.45
|
|
|
ALTEPLASE 1 MG/2 ML SYRINGE [408189]
|
Facility
|
IP
|
$52.80
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.00
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.45
|
| Rate for Payer: Heritage Provider Network Senior |
$24.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$39.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.48
|
|
|
ALTEPLASE 1 MG/2 ML SYRINGE [408189]
|
Facility
|
OP
|
$52.80
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$132.11 |
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.89
|
| Rate for Payer: Blue Shield of California Commercial |
$89.85
|
| Rate for Payer: Blue Shield of California EPN |
$89.85
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$123.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$98.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.45
|
| Rate for Payer: Heritage Provider Network Senior |
$24.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$98.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$113.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$132.11
|
| Rate for Payer: Multiplan Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.12
|
| Rate for Payer: TriValley Medical Group Senior |
$21.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Vantage Medical Group Senior |
$108.45
|
|
|
ALTEPLASE 2 MG INTRA-ARTERIAL SOLUTION FOR IR [40823708]
|
Facility
|
OP
|
$52.80
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$132.11 |
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.89
|
| Rate for Payer: Blue Shield of California Commercial |
$89.85
|
| Rate for Payer: Blue Shield of California EPN |
$89.85
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$123.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$98.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.45
|
| Rate for Payer: Heritage Provider Network Senior |
$24.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$98.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$113.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$132.11
|
| Rate for Payer: Multiplan Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.12
|
| Rate for Payer: TriValley Medical Group Senior |
$21.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Vantage Medical Group Senior |
$108.45
|
|
|
ALTEPLASE 2 MG INTRA-ARTERIAL SOLUTION FOR IR [40823708]
|
Facility
|
IP
|
$52.80
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.00
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.45
|
| Rate for Payer: Heritage Provider Network Senior |
$24.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$39.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.48
|
|
|
ALTEPLASE 50 MG INTRAVENOUS SOLUTION [9003]
|
Facility
|
IP
|
$5,280.22
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$955.72 |
| Max. Negotiated Rate |
$3,960.16 |
| Rate for Payer: Adventist Health Commercial |
$1,056.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,400.46
|
| Rate for Payer: Cash Price |
$2,376.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,428.90
|
| Rate for Payer: EPIC Health Plan Commercial |
$2,851.32
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,444.74
|
| Rate for Payer: Heritage Provider Network Senior |
$2,444.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$955.72
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,320.06
|
| Rate for Payer: Multiplan Commercial |
$3,960.16
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,907.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,748.28
|
|
|
ALTEPLASE 50 MG INTRAVENOUS SOLUTION [9003]
|
Facility
|
OP
|
$5,280.22
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$75.89 |
| Max. Negotiated Rate |
$3,960.16 |
| Rate for Payer: Adventist Health Commercial |
$1,056.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$3,263.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.89
|
| Rate for Payer: Blue Shield of California Commercial |
$89.85
|
| Rate for Payer: Blue Shield of California EPN |
$89.85
|
| Rate for Payer: Cash Price |
$2,376.10
|
| Rate for Payer: Cash Price |
$2,376.10
|
| Rate for Payer: Cigna of CA HMO/PPO |
$2,428.90
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$123.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$3,379.34
|
| Rate for Payer: EPIC Health Plan Medicare |
$98.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$2,444.74
|
| Rate for Payer: Heritage Provider Network Senior |
$2,444.74
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$98.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$2,518.66
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$955.72
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$113.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$1,320.06
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$132.11
|
| Rate for Payer: Multiplan Commercial |
$3,960.16
|
| Rate for Payer: TriValley Medical Group Commercial |
$2,112.09
|
| Rate for Payer: TriValley Medical Group Senior |
$2,112.09
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$1,907.74
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$1,748.28
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Vantage Medical Group Senior |
$108.45
|
|
|
ALTEPLASE INTRAVENTRICULAR 1 MG/2 ML SYRINGE [40820125]
|
Facility
|
OP
|
$52.80
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$132.11 |
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.89
|
| Rate for Payer: Blue Shield of California Commercial |
$89.85
|
| Rate for Payer: Blue Shield of California EPN |
$89.85
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$123.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$98.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.45
|
| Rate for Payer: Heritage Provider Network Senior |
$24.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$98.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$113.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$132.11
|
| Rate for Payer: Multiplan Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.12
|
| Rate for Payer: TriValley Medical Group Senior |
$21.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Vantage Medical Group Senior |
$108.45
|
|
|
ALTEPLASE INTRAVENTRICULAR 1 MG/2 ML SYRINGE [40820125]
|
Facility
|
IP
|
$52.80
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.00
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.45
|
| Rate for Payer: Heritage Provider Network Senior |
$24.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$39.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.48
|
|
|
ALTEPLASE SYRINGE 1 MG/2 ML FOR NEBULIZATION [4081953]
|
Facility
|
IP
|
$52.80
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$39.60 |
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$34.00
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.29
|
| Rate for Payer: EPIC Health Plan Commercial |
$28.51
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.45
|
| Rate for Payer: Heritage Provider Network Senior |
$24.45
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.56
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Multiplan Commercial |
$39.60
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.48
|
|
|
ALTEPLASE SYRINGE 1 MG/2 ML FOR NEBULIZATION [4081953]
|
Facility
|
OP
|
$52.80
|
|
|
Service Code
|
HCPCS J2997
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$9.56 |
| Max. Negotiated Rate |
$132.11 |
| Rate for Payer: Adventist Health Commercial |
$10.56
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$32.63
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$108.45
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$75.89
|
| Rate for Payer: Blue Shield of California Commercial |
$89.85
|
| Rate for Payer: Blue Shield of California EPN |
$89.85
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cash Price |
$23.76
|
| Rate for Payer: Cigna of CA HMO/PPO |
$24.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$123.24
|
| Rate for Payer: Dignity Health Medi-Cal |
$108.45
|
| Rate for Payer: Dignity Health Medicare Advantage |
$108.45
|
| Rate for Payer: EPIC Health Plan Commercial |
$33.79
|
| Rate for Payer: EPIC Health Plan Medicare |
$98.59
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.45
|
| Rate for Payer: Heritage Provider Network Senior |
$24.45
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$98.59
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$25.19
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$9.56
|
| Rate for Payer: Kaiser Foundation Hospitals Medicare Advantage |
$113.38
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$13.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$132.11
|
| Rate for Payer: Multiplan Commercial |
$39.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$21.12
|
| Rate for Payer: TriValley Medical Group Senior |
$21.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$17.48
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$123.24
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$108.45
|
| Rate for Payer: Vantage Medical Group Senior |
$108.45
|
|
|
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION [353]
|
Facility
|
OP
|
$0.02
|
|
|
Service Code
|
NDC 0536009185
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.02
|
| Rate for Payer: Vantage Medical Group Senior |
$0.02
|
|
|
ALUMINUM HYDROXIDE GEL 320 MG/5 ML ORAL SUSPENSION [353]
|
Facility
|
IP
|
$0.02
|
|
|
Service Code
|
NDC 0536009185
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
|
|
ALUMINUM HYDROX-MAGNESIUM CARB 95 MG-358 MG/15 ML ORAL SUSPENSION [24314]
|
Facility
|
IP
|
$0.02
|
|
|
Service Code
|
NDC 0904772714
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
|
|
ALUMINUM HYDROX-MAGNESIUM CARB 95 MG-358 MG/15 ML ORAL SUSPENSION [24314]
|
Facility
|
OP
|
$0.02
|
|
|
Service Code
|
NDC 0904772714
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.02
|
| Rate for Payer: Vantage Medical Group Senior |
$0.02
|
|
|
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP [38285]
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
NDC 0536129383
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.00
|
| Rate for Payer: TriValley Medical Group Senior |
$0.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
|
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP [38285]
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
NDC 0536129383
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP [38285]
|
Facility
|
OP
|
$0.02
|
|
|
Service Code
|
NDC 9994083828
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.02
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.02
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.02
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.02
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Senior |
$0.01
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.02
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.02
|
| Rate for Payer: Vantage Medical Group Senior |
$0.02
|
|
|
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP [38285]
|
Facility
|
IP
|
$0.13
|
|
|
Service Code
|
NDC 0121176130
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.10 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.08
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.07
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Senior |
$0.09
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Multiplan Commercial |
$0.10
|
|
|
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP [38285]
|
Facility
|
OP
|
$0.13
|
|
|
Service Code
|
NDC 0121176130
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.11 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.08
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.11
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.07
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.10
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.07
|
| Rate for Payer: Blue Shield of California Commercial |
$0.08
|
| Rate for Payer: Blue Shield of California EPN |
$0.06
|
| Rate for Payer: Cash Price |
$0.06
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.11
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.11
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.11
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.08
|
| Rate for Payer: Heritage Provider Network Senior |
$0.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.09
|
| Rate for Payer: Multiplan Commercial |
$0.10
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.05
|
| Rate for Payer: TriValley Medical Group Senior |
$0.05
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.07
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.07
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.11
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.11
|
| Rate for Payer: Vantage Medical Group Senior |
$0.11
|
|
|
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP [38285]
|
Facility
|
IP
|
$0.01
|
|
|
Service Code
|
NDC 5789662912
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
|
|
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP [38285]
|
Facility
|
IP
|
$0.02
|
|
|
Service Code
|
NDC 9994083828
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.02 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Cash Price |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.02
|
|
|
ALUMINUM-MAG HYDROXIDE-SIMETHICONE 200 MG-200 MG-20 MG/5 ML ORAL SUSP [38285]
|
Facility
|
OP
|
$0.01
|
|
|
Service Code
|
NDC 5789662912
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Max. Negotiated Rate |
$0.01 |
| Rate for Payer: Adventist Health Commercial |
$0.00
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.01
|
| Rate for Payer: Blue Shield of California Commercial |
$0.01
|
| Rate for Payer: Blue Shield of California EPN |
$0.00
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.01
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.01
|
| Rate for Payer: Heritage Provider Network Senior |
$0.01
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.00
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.01
|
| Rate for Payer: Multiplan Commercial |
$0.01
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.00
|
| Rate for Payer: TriValley Medical Group Senior |
$0.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.01
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.01
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.01
|
| Rate for Payer: Vantage Medical Group Senior |
$0.01
|
|
