|
CARBOXYMETHYLCELLULOSE SODIUM 1 % EYE GEL IN A DROPPERETTE [38321]
|
Facility
|
OP
|
$0.44
|
|
|
Service Code
|
NDC 0023-4554-30
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.08 |
| Max. Negotiated Rate |
$0.37 |
| Rate for Payer: Adventist Health Commercial |
$0.09
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.24
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.30
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.37
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.33
|
| Rate for Payer: Blue Shield of California Commercial |
$0.27
|
| Rate for Payer: Blue Shield of California EPN |
$0.21
|
| Rate for Payer: Cash Price |
$0.24
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.29
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.37
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.37
|
| Rate for Payer: Dignity Health Senior |
$0.37
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.28
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.27
|
| Rate for Payer: Heritage Provider Network Senior |
$0.27
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.21
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.08
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.11
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.31
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.31
|
| Rate for Payer: Multiplan Commercial |
$0.33
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.18
|
| Rate for Payer: TriValley Medical Group Senior |
$0.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.22
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.22
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.37
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.37
|
| Rate for Payer: Vantage Medical Group Senior |
$0.37
|
|
|
CARBOXYMETHYLCELLULOSE SODIUM 1 % EYE LIQUID GEL DROPS [27992]
|
Facility
|
IP
|
$0.69
|
|
|
Service Code
|
NDC 0023-9205-15
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.52 |
| Rate for Payer: Adventist Health Commercial |
$0.14
|
| Rate for Payer: Cash Price |
$0.38
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.37
|
| 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 |
$0.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.17
|
| Rate for Payer: Multiplan Commercial |
$0.52
|
|
|
CARBOXYMETHYLCELLULOSE SODIUM 1 % EYE LIQUID GEL DROPS [27992]
|
Facility
|
OP
|
$0.69
|
|
|
Service Code
|
NDC 0023-9205-15
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.12 |
| Max. Negotiated Rate |
$0.59 |
| 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 |
$0.47
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.38
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.52
|
| Rate for Payer: Blue Shield of California Commercial |
$0.42
|
| 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 |
$0.45
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.59
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.59
|
| Rate for Payer: Dignity Health Senior |
$0.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.44
|
| 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 |
$0.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.17
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.48
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.48
|
| Rate for Payer: Multiplan Commercial |
$0.52
|
| 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 |
$0.59
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Vantage Medical Group Senior |
$0.59
|
|
|
CARFILZOMIB 10 MG INTRAVENOUS SOLUTION [222456]
|
Facility
|
OP
|
$707.44
|
|
|
Service Code
|
HCPCS J9047
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$51.85 |
| Max. Negotiated Rate |
$530.58 |
| Rate for Payer: Adventist Health Commercial |
$141.49
|
| Rate for Payer: Aetna of CA Gatekeeper |
$378.13
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$486.01
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.64
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$60.60
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$60.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$152.68
|
| Rate for Payer: Blue Shield of California Commercial |
$55.67
|
| Rate for Payer: Blue Shield of California EPN |
$55.67
|
| Rate for Payer: Cash Price |
$389.09
|
| Rate for Payer: Cash Price |
$389.09
|
| Rate for Payer: Cigna of CA HMO/PPO |
$325.42
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$68.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$60.60
|
| Rate for Payer: Dignity Health Senior |
$60.60
|
| Rate for Payer: EPIC Health Plan Commercial |
$452.76
|
| Rate for Payer: EPIC Health Plan Medicare |
$55.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$327.54
|
| Rate for Payer: Heritage Provider Network Senior |
$327.54
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$51.85
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$337.45
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$128.05
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$63.35
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.86
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$69.41
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$69.41
|
| Rate for Payer: Multiplan Commercial |
$530.58
|
| Rate for Payer: TriValley Medical Group Commercial |
$282.98
|
| Rate for Payer: TriValley Medical Group Senior |
$282.98
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$255.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$234.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$68.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$60.60
|
| Rate for Payer: Vantage Medical Group Senior |
$60.60
|
|
|
CARFILZOMIB 10 MG INTRAVENOUS SOLUTION [222456]
|
Facility
|
IP
|
$707.44
|
|
|
Service Code
|
HCPCS J9047
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$128.05 |
| Max. Negotiated Rate |
$530.58 |
| Rate for Payer: Adventist Health Commercial |
$141.49
|
| Rate for Payer: Cash Price |
$389.09
|
| Rate for Payer: Cigna of CA HMO/PPO |
$325.42
|
| Rate for Payer: EPIC Health Plan Commercial |
$382.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$327.54
|
| Rate for Payer: Heritage Provider Network Senior |
$327.54
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$128.05
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$176.86
|
| Rate for Payer: Multiplan Commercial |
$530.58
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$255.60
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$234.23
|
|
|
CARISOPRODOL 350 MG TABLET [1395]
|
Facility
|
IP
|
$0.08
|
|
|
Service Code
|
NDC 69584-111-10
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Cash Price |
$0.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.05
|
| Rate for Payer: Heritage Provider Network Senior |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Multiplan Commercial |
$0.06
|
|
|
CARISOPRODOL 350 MG TABLET [1395]
|
Facility
|
IP
|
$0.14
|
|
|
Service Code
|
NDC 50228-109-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.11 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$0.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.08
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Senior |
$0.09
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
|
|
CARISOPRODOL 350 MG TABLET [1395]
|
Facility
|
OP
|
$0.08
|
|
|
Service Code
|
NDC 69584-111-10
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.07 |
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.07
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.06
|
| Rate for Payer: Blue Shield of California Commercial |
$0.05
|
| Rate for Payer: Blue Shield of California EPN |
$0.04
|
| Rate for Payer: Cash Price |
$0.05
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.07
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.07
|
| Rate for Payer: Dignity Health Senior |
$0.07
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.05
|
| Rate for Payer: Heritage Provider Network Senior |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.06
|
| Rate for Payer: Multiplan Commercial |
$0.06
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.03
|
| Rate for Payer: TriValley Medical Group Senior |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.07
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.07
|
| Rate for Payer: Vantage Medical Group Senior |
$0.07
|
|
|
CARISOPRODOL 350 MG TABLET [1395]
|
Facility
|
OP
|
$0.14
|
|
|
Service Code
|
NDC 50228-109-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.12 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.07
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.10
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.12
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.08
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.11
|
| Rate for Payer: Blue Shield of California Commercial |
$0.09
|
| Rate for Payer: Blue Shield of California EPN |
$0.07
|
| Rate for Payer: Cash Price |
$0.08
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.09
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.12
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.12
|
| Rate for Payer: Dignity Health Senior |
$0.12
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Senior |
$0.09
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.10
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.10
|
| Rate for Payer: Multiplan Commercial |
$0.11
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.06
|
| Rate for Payer: TriValley Medical Group Senior |
$0.06
|
| 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 |
$0.12
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.12
|
| Rate for Payer: Vantage Medical Group Senior |
$0.12
|
|
|
CARMUSTINE 100 MG INTRAVENOUS SOLUTION [28911]
|
Facility
|
OP
|
$421.20
|
|
|
Service Code
|
HCPCS J9050
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$76.24 |
| Max. Negotiated Rate |
$1,693.19 |
| Rate for Payer: Adventist Health Commercial |
$84.24
|
| Rate for Payer: Adventist Health Commercial |
$129.60
|
| Rate for Payer: Aetna of CA Gatekeeper |
$225.13
|
| Rate for Payer: Aetna of CA Gatekeeper |
$346.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$289.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$445.18
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$260.46
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$260.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$191.01
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$191.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$191.01
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$191.01
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,693.19
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$1,693.19
|
| Rate for Payer: Blue Shield of California Commercial |
$765.00
|
| Rate for Payer: Blue Shield of California Commercial |
$765.00
|
| Rate for Payer: Blue Shield of California EPN |
$765.00
|
| Rate for Payer: Blue Shield of California EPN |
$765.00
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cash Price |
$231.66
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cash Price |
$231.66
|
| Rate for Payer: Cigna of CA HMO/PPO |
$193.75
|
| Rate for Payer: Cigna of CA HMO/PPO |
$298.08
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$217.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$217.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$191.01
|
| Rate for Payer: Dignity Health Medi-Cal |
$191.01
|
| Rate for Payer: Dignity Health Senior |
$191.01
|
| Rate for Payer: Dignity Health Senior |
$191.01
|
| Rate for Payer: EPIC Health Plan Commercial |
$269.57
|
| Rate for Payer: EPIC Health Plan Commercial |
$414.72
|
| Rate for Payer: EPIC Health Plan Medicare |
$173.64
|
| Rate for Payer: EPIC Health Plan Medicare |
$173.64
|
| Rate for Payer: Heritage Provider Network Commercial |
$195.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$300.02
|
| Rate for Payer: Heritage Provider Network Senior |
$195.02
|
| Rate for Payer: Heritage Provider Network Senior |
$300.02
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$145.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medi-Cal |
$145.60
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$173.64
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$173.64
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$309.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$200.91
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$76.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$199.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$199.69
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.30
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$218.79
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$218.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$218.79
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$218.79
|
| Rate for Payer: Multiplan Commercial |
$315.90
|
| Rate for Payer: Multiplan Commercial |
$486.00
|
| Rate for Payer: TriValley Medical Group Commercial |
$259.20
|
| Rate for Payer: TriValley Medical Group Commercial |
$168.48
|
| Rate for Payer: TriValley Medical Group Senior |
$168.48
|
| Rate for Payer: TriValley Medical Group Senior |
$259.20
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$234.12
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$152.18
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$139.46
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$214.55
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$217.05
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$217.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$191.01
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$191.01
|
| Rate for Payer: Vantage Medical Group Senior |
$191.01
|
| Rate for Payer: Vantage Medical Group Senior |
$191.01
|
|
|
CARMUSTINE 100 MG INTRAVENOUS SOLUTION [28911]
|
Facility
|
IP
|
$648.00
|
|
|
Service Code
|
HCPCS J9050
|
| Hospital Charge Code |
901700025
|
|
Hospital Revenue Code
|
636
|
| Min. Negotiated Rate |
$117.29 |
| Max. Negotiated Rate |
$486.00 |
| Rate for Payer: Adventist Health Commercial |
$129.60
|
| Rate for Payer: Adventist Health Commercial |
$84.24
|
| Rate for Payer: Cash Price |
$356.40
|
| Rate for Payer: Cash Price |
$231.66
|
| Rate for Payer: Cigna of CA HMO/PPO |
$298.08
|
| Rate for Payer: Cigna of CA HMO/PPO |
$193.75
|
| Rate for Payer: EPIC Health Plan Commercial |
$349.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$227.45
|
| Rate for Payer: Heritage Provider Network Commercial |
$195.02
|
| Rate for Payer: Heritage Provider Network Commercial |
$300.02
|
| Rate for Payer: Heritage Provider Network Senior |
$300.02
|
| Rate for Payer: Heritage Provider Network Senior |
$195.02
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$76.24
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$117.29
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$162.00
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$105.30
|
| Rate for Payer: Multiplan Commercial |
$315.90
|
| Rate for Payer: Multiplan Commercial |
$486.00
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$152.18
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$234.12
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$214.55
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$139.46
|
|
|
CARMUSTINE 50 MG INTRAVENOUS SOLUTION [234861]
|
Facility
|
IP
|
$147.00
|
|
|
Service Code
|
NDC 16729-545-63
|
| Min. Negotiated Rate |
$26.61 |
| Max. Negotiated Rate |
$110.25 |
| Rate for Payer: Adventist Health Commercial |
$29.40
|
| Rate for Payer: Cash Price |
$80.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$99.52
|
| Rate for Payer: Heritage Provider Network Senior |
$99.52
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.75
|
| Rate for Payer: Multiplan Commercial |
$110.25
|
|
|
CARMUSTINE 50 MG INTRAVENOUS SOLUTION [234861]
|
Facility
|
OP
|
$147.00
|
|
|
Service Code
|
NDC 16729-545-63
|
| Min. Negotiated Rate |
$26.61 |
| Max. Negotiated Rate |
$124.95 |
| Rate for Payer: Adventist Health Commercial |
$29.40
|
| Rate for Payer: Aetna of CA Gatekeeper |
$78.57
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$100.99
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$124.95
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$80.85
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$110.25
|
| Rate for Payer: Blue Shield of California Commercial |
$89.67
|
| Rate for Payer: Blue Shield of California EPN |
$71.74
|
| Rate for Payer: Cash Price |
$80.85
|
| Rate for Payer: Cigna of CA HMO/PPO |
$95.55
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$124.95
|
| Rate for Payer: Dignity Health Medi-Cal |
$124.95
|
| Rate for Payer: Dignity Health Senior |
$124.95
|
| Rate for Payer: EPIC Health Plan Commercial |
$95.55
|
| Rate for Payer: Heritage Provider Network Commercial |
$90.99
|
| Rate for Payer: Heritage Provider Network Senior |
$90.99
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$70.12
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$26.61
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$36.75
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$102.90
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$102.90
|
| Rate for Payer: Multiplan Commercial |
$110.25
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$73.50
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$73.50
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$124.95
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$124.95
|
| Rate for Payer: Vantage Medical Group Senior |
$124.95
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
IP
|
$0.16
|
|
|
Service Code
|
NDC 51079-931-20
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.12 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.11
|
| Rate for Payer: Heritage Provider Network Senior |
$0.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.12
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
OP
|
$0.06
|
|
|
Service Code
|
NDC 65862-144-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.05
|
| Rate for Payer: Blue Shield of California Commercial |
$0.04
|
| Rate for Payer: Blue Shield of California EPN |
$0.03
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.05
|
| Rate for Payer: Dignity Health Senior |
$0.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Senior |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.02
|
| Rate for Payer: TriValley Medical Group Senior |
$0.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.03
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
| Rate for Payer: Vantage Medical Group Senior |
$0.05
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
IP
|
$0.06
|
|
|
Service Code
|
NDC 68001-151-00
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Senior |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
OP
|
$0.07
|
|
|
Service Code
|
NDC 0093-7295-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.06 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.04
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.05
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.06
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.04
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.05
|
| Rate for Payer: Blue Shield of California Commercial |
$0.04
|
| Rate for Payer: Blue Shield of California EPN |
$0.03
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.05
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.06
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.06
|
| Rate for Payer: Dignity Health Senior |
$0.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Senior |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.05
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.05
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.03
|
| Rate for Payer: TriValley Medical Group Senior |
$0.03
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.04
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.04
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.06
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.06
|
| Rate for Payer: Vantage Medical Group Senior |
$0.06
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
IP
|
$0.10
|
|
|
Service Code
|
NDC 0904-6302-61
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.02 |
| Max. Negotiated Rate |
$0.08 |
| Rate for Payer: Adventist Health Commercial |
$0.02
|
| Rate for Payer: Cash Price |
$0.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.05
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.07
|
| Rate for Payer: Heritage Provider Network Senior |
$0.07
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.02
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.03
|
| Rate for Payer: Multiplan Commercial |
$0.08
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
OP
|
$0.16
|
|
|
Service Code
|
NDC 51079-931-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.12
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California EPN |
$0.08
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.14
|
| Rate for Payer: Dignity Health Senior |
$0.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.10
|
| Rate for Payer: Heritage Provider Network Senior |
$0.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.11
|
| Rate for Payer: Multiplan Commercial |
$0.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.06
|
| Rate for Payer: TriValley Medical Group Senior |
$0.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: Vantage Medical Group Senior |
$0.14
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
OP
|
$0.16
|
|
|
Service Code
|
NDC 51079-931-20
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.14 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.09
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.11
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.14
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.09
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.12
|
| Rate for Payer: Blue Shield of California Commercial |
$0.10
|
| Rate for Payer: Blue Shield of California EPN |
$0.08
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.10
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.14
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.14
|
| Rate for Payer: Dignity Health Senior |
$0.14
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.10
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.10
|
| Rate for Payer: Heritage Provider Network Senior |
$0.10
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.08
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.11
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.11
|
| Rate for Payer: Multiplan Commercial |
$0.12
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.06
|
| Rate for Payer: TriValley Medical Group Senior |
$0.06
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.08
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.08
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.14
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.14
|
| Rate for Payer: Vantage Medical Group Senior |
$0.14
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
IP
|
$0.07
|
|
|
Service Code
|
NDC 0093-7295-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.05
|
| Rate for Payer: Heritage Provider Network Senior |
$0.05
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
IP
|
$0.16
|
|
|
Service Code
|
NDC 51079-931-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.03 |
| Max. Negotiated Rate |
$0.12 |
| Rate for Payer: Adventist Health Commercial |
$0.03
|
| Rate for Payer: Cash Price |
$0.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.09
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.11
|
| Rate for Payer: Heritage Provider Network Senior |
$0.11
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.03
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.12
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
OP
|
$0.06
|
|
|
Service Code
|
NDC 68382-094-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.05
|
| Rate for Payer: Blue Shield of California Commercial |
$0.04
|
| Rate for Payer: Blue Shield of California EPN |
$0.03
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.05
|
| Rate for Payer: Dignity Health Senior |
$0.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Senior |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.02
|
| Rate for Payer: TriValley Medical Group Senior |
$0.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.03
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
| Rate for Payer: Vantage Medical Group Senior |
$0.05
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
IP
|
$0.06
|
|
|
Service Code
|
NDC 65862-144-01
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.03
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Senior |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
|
|
CARVEDILOL 12.5 MG TABLET [15749]
|
Facility
|
OP
|
$0.06
|
|
|
Service Code
|
NDC 68001-151-00
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.01 |
| Max. Negotiated Rate |
$0.05 |
| Rate for Payer: Adventist Health Commercial |
$0.01
|
| Rate for Payer: Aetna of CA Gatekeeper |
$0.03
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.04
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.05
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.03
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.05
|
| Rate for Payer: Blue Shield of California Commercial |
$0.04
|
| Rate for Payer: Blue Shield of California EPN |
$0.03
|
| Rate for Payer: Cash Price |
$0.03
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.04
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.05
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.05
|
| Rate for Payer: Dignity Health Senior |
$0.05
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.04
|
| Rate for Payer: Heritage Provider Network Senior |
$0.04
|
| Rate for Payer: Kaiser Permanente of CA Commercial |
$0.03
|
| Rate for Payer: Kaiser Permanente of CA Medi-Cal |
$0.01
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.02
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal |
$0.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$0.04
|
| Rate for Payer: Multiplan Commercial |
$0.05
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.02
|
| Rate for Payer: TriValley Medical Group Senior |
$0.02
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.03
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.03
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.05
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.05
|
| Rate for Payer: Vantage Medical Group Senior |
$0.05
|
|
