|
CINACALCET 30 MG TABLET [38100]
|
Facility
|
OP
|
$0.60
|
|
|
Service Code
|
NDC 6586283130
|
| 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 Non-Gatekeeper |
$0.37
|
| 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: Anthem Blue Cross of CA HMO/PPO |
$0.30
|
| 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 |
$0.27
|
| 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 Medicare Advantage |
$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 Foundation Hospitals Commercial |
$0.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/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
|
|
|
CINACALCET 30 MG TABLET [38100]
|
Facility
|
OP
|
$0.60
|
|
|
Service Code
|
NDC 6909741002
|
| 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 Non-Gatekeeper |
$0.37
|
| 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: Anthem Blue Cross of CA HMO/PPO |
$0.30
|
| 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 |
$0.27
|
| 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 Medicare Advantage |
$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 Foundation Hospitals Commercial |
$0.29
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.11
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.15
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/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
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 6438088404
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.54
|
| Rate for Payer: Blue Shield of California Commercial |
$0.66
|
| Rate for Payer: Blue Shield of California EPN |
$0.53
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.67
|
| Rate for Payer: Heritage Provider Network Senior |
$0.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 6586283230
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.54
|
| Rate for Payer: Blue Shield of California Commercial |
$0.66
|
| Rate for Payer: Blue Shield of California EPN |
$0.53
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.67
|
| Rate for Payer: Heritage Provider Network Senior |
$0.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 1672944110
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.81 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.70
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.73
|
| Rate for Payer: Heritage Provider Network Senior |
$0.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 7043600804
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.54
|
| Rate for Payer: Blue Shield of California Commercial |
$0.66
|
| Rate for Payer: Blue Shield of California EPN |
$0.53
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.67
|
| Rate for Payer: Heritage Provider Network Senior |
$0.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 6438088404
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.81 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.70
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.73
|
| Rate for Payer: Heritage Provider Network Senior |
$0.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 6787750430
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.54
|
| Rate for Payer: Blue Shield of California Commercial |
$0.66
|
| Rate for Payer: Blue Shield of California EPN |
$0.53
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.67
|
| Rate for Payer: Heritage Provider Network Senior |
$0.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 6787750430
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.81 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.70
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.73
|
| Rate for Payer: Heritage Provider Network Senior |
$0.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 7043600804
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.81 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.70
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.73
|
| Rate for Payer: Heritage Provider Network Senior |
$0.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$64.54
|
|
|
Service Code
|
NDC 5551307430
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$11.68 |
| Max. Negotiated Rate |
$54.86 |
| Rate for Payer: Adventist Health Commercial |
$12.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$39.89
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$54.86
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$35.50
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$48.41
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$32.28
|
| Rate for Payer: Blue Shield of California Commercial |
$39.37
|
| Rate for Payer: Blue Shield of California EPN |
$31.50
|
| Rate for Payer: Cash Price |
$29.04
|
| Rate for Payer: Cigna of CA HMO/PPO |
$41.95
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$54.86
|
| Rate for Payer: Dignity Health Medi-Cal |
$54.86
|
| Rate for Payer: Dignity Health Medicare Advantage |
$54.86
|
| Rate for Payer: EPIC Health Plan Commercial |
$41.31
|
| Rate for Payer: Heritage Provider Network Commercial |
$39.95
|
| Rate for Payer: Heritage Provider Network Senior |
$39.95
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$30.79
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.14
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$45.18
|
| Rate for Payer: Multiplan Commercial |
$48.41
|
| Rate for Payer: TriValley Medical Group Commercial |
$25.82
|
| Rate for Payer: TriValley Medical Group Senior |
$25.82
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$32.27
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$32.27
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$54.86
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$54.86
|
| Rate for Payer: Vantage Medical Group Senior |
$54.86
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 6909741102
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.54
|
| Rate for Payer: Blue Shield of California Commercial |
$0.66
|
| Rate for Payer: Blue Shield of California EPN |
$0.53
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.67
|
| Rate for Payer: Heritage Provider Network Senior |
$0.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 6586283230
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.81 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.70
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.73
|
| Rate for Payer: Heritage Provider Network Senior |
$0.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
OP
|
$1.08
|
|
|
Service Code
|
NDC 1672944110
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.92 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.67
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.59
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$0.81
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.54
|
| Rate for Payer: Blue Shield of California Commercial |
$0.66
|
| Rate for Payer: Blue Shield of California EPN |
$0.53
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: Cigna of CA HMO/PPO |
$0.70
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$0.92
|
| Rate for Payer: Dignity Health Medi-Cal |
$0.92
|
| Rate for Payer: Dignity Health Medicare Advantage |
$0.92
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.69
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.67
|
| Rate for Payer: Heritage Provider Network Senior |
$0.67
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.52
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$0.76
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.43
|
| Rate for Payer: TriValley Medical Group Senior |
$0.43
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.54
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.54
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$0.92
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$0.92
|
| Rate for Payer: Vantage Medical Group Senior |
$0.92
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$1.08
|
|
|
Service Code
|
NDC 6909741102
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.20 |
| Max. Negotiated Rate |
$0.81 |
| Rate for Payer: Adventist Health Commercial |
$0.22
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.70
|
| Rate for Payer: Cash Price |
$0.49
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.58
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.73
|
| Rate for Payer: Heritage Provider Network Senior |
$0.73
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.20
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.27
|
| Rate for Payer: Multiplan Commercial |
$0.81
|
|
|
CINACALCET 60 MG TABLET [38101]
|
Facility
|
IP
|
$64.54
|
|
|
Service Code
|
NDC 5551307430
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$11.68 |
| Max. Negotiated Rate |
$48.41 |
| Rate for Payer: Adventist Health Commercial |
$12.91
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$41.56
|
| Rate for Payer: Cash Price |
$29.04
|
| Rate for Payer: EPIC Health Plan Commercial |
$34.85
|
| Rate for Payer: Heritage Provider Network Commercial |
$43.69
|
| Rate for Payer: Heritage Provider Network Senior |
$43.69
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$11.68
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$16.14
|
| Rate for Payer: Multiplan Commercial |
$48.41
|
|
|
CINACALCET 90 MG TABLET [38102]
|
Facility
|
OP
|
$96.80
|
|
|
Service Code
|
NDC 5551307530
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$17.52 |
| Max. Negotiated Rate |
$82.28 |
| Rate for Payer: Adventist Health Commercial |
$19.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$59.82
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$82.28
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$53.24
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$72.60
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$48.42
|
| Rate for Payer: Blue Shield of California Commercial |
$59.05
|
| Rate for Payer: Blue Shield of California EPN |
$47.24
|
| Rate for Payer: Cash Price |
$43.56
|
| Rate for Payer: Cigna of CA HMO/PPO |
$62.92
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$82.28
|
| Rate for Payer: Dignity Health Medi-Cal |
$82.28
|
| Rate for Payer: Dignity Health Medicare Advantage |
$82.28
|
| Rate for Payer: EPIC Health Plan Commercial |
$61.95
|
| Rate for Payer: Heritage Provider Network Commercial |
$59.92
|
| Rate for Payer: Heritage Provider Network Senior |
$59.92
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$46.17
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.20
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$67.76
|
| Rate for Payer: Multiplan Commercial |
$72.60
|
| Rate for Payer: TriValley Medical Group Commercial |
$38.72
|
| Rate for Payer: TriValley Medical Group Senior |
$38.72
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$48.40
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$48.40
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$82.28
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$82.28
|
| Rate for Payer: Vantage Medical Group Senior |
$82.28
|
|
|
CINACALCET 90 MG TABLET [38102]
|
Facility
|
IP
|
$96.80
|
|
|
Service Code
|
NDC 5551307530
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$17.52 |
| Max. Negotiated Rate |
$72.60 |
| Rate for Payer: Adventist Health Commercial |
$19.36
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$62.34
|
| Rate for Payer: Cash Price |
$43.56
|
| Rate for Payer: EPIC Health Plan Commercial |
$52.27
|
| Rate for Payer: Heritage Provider Network Commercial |
$65.53
|
| Rate for Payer: Heritage Provider Network Senior |
$65.53
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$17.52
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$24.20
|
| Rate for Payer: Multiplan Commercial |
$72.60
|
|
|
CINACALCET 90 MG TABLET [38102]
|
Facility
|
OP
|
$1.56
|
|
|
Service Code
|
NDC 6787750530
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$1.33 |
| Rate for Payer: Adventist Health Commercial |
$0.31
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$0.96
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$1.33
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$0.86
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$1.17
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$0.78
|
| Rate for Payer: Blue Shield of California Commercial |
$0.95
|
| Rate for Payer: Blue Shield of California EPN |
$0.76
|
| Rate for Payer: Cash Price |
$0.70
|
| Rate for Payer: Cigna of CA HMO/PPO |
$1.01
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$1.33
|
| Rate for Payer: Dignity Health Medi-Cal |
$1.33
|
| Rate for Payer: Dignity Health Medicare Advantage |
$1.33
|
| Rate for Payer: EPIC Health Plan Commercial |
$1.00
|
| Rate for Payer: Heritage Provider Network Commercial |
$0.97
|
| Rate for Payer: Heritage Provider Network Senior |
$0.97
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$0.74
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.39
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$1.09
|
| Rate for Payer: Multiplan Commercial |
$1.17
|
| Rate for Payer: TriValley Medical Group Commercial |
$0.62
|
| Rate for Payer: TriValley Medical Group Senior |
$0.62
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$0.78
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$0.78
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$1.33
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$1.33
|
| Rate for Payer: Vantage Medical Group Senior |
$1.33
|
|
|
CINACALCET 90 MG TABLET [38102]
|
Facility
|
IP
|
$1.56
|
|
|
Service Code
|
NDC 6787750530
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$0.28 |
| Max. Negotiated Rate |
$1.17 |
| Rate for Payer: Adventist Health Commercial |
$0.31
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$1.00
|
| Rate for Payer: Cash Price |
$0.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$0.84
|
| Rate for Payer: Heritage Provider Network Commercial |
$1.06
|
| Rate for Payer: Heritage Provider Network Senior |
$1.06
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$0.28
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$0.39
|
| Rate for Payer: Multiplan Commercial |
$1.17
|
|
|
CIPROFLOXACIN 0.2 %-HYDROCORTISONE 1 % EAR DROPS,SUSPENSION [22986]
|
Facility
|
IP
|
$43.74
|
|
|
Service Code
|
NDC 6675808770
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$32.80 |
| Rate for Payer: Adventist Health Commercial |
$8.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$28.17
|
| Rate for Payer: Cash Price |
$19.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$23.62
|
| Rate for Payer: Heritage Provider Network Commercial |
$29.61
|
| Rate for Payer: Heritage Provider Network Senior |
$29.61
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.94
|
| Rate for Payer: Multiplan Commercial |
$32.80
|
|
|
CIPROFLOXACIN 0.2 %-HYDROCORTISONE 1 % EAR DROPS,SUSPENSION [22986]
|
Facility
|
IP
|
$39.36
|
|
|
Service Code
|
NDC 0713085109
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$29.52 |
| Rate for Payer: Adventist Health Commercial |
$7.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$25.35
|
| Rate for Payer: Cash Price |
$17.71
|
| Rate for Payer: EPIC Health Plan Commercial |
$21.25
|
| Rate for Payer: Heritage Provider Network Commercial |
$26.65
|
| Rate for Payer: Heritage Provider Network Senior |
$26.65
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.84
|
| Rate for Payer: Multiplan Commercial |
$29.52
|
|
|
CIPROFLOXACIN 0.2 %-HYDROCORTISONE 1 % EAR DROPS,SUSPENSION [22986]
|
Facility
|
OP
|
$39.36
|
|
|
Service Code
|
NDC 0713085109
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.12 |
| Max. Negotiated Rate |
$33.46 |
| Rate for Payer: Vantage Medical Group Medi-Cal |
$33.46
|
| Rate for Payer: Adventist Health Commercial |
$7.87
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$24.32
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$33.46
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$21.65
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$29.52
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$19.69
|
| Rate for Payer: Blue Shield of California Commercial |
$24.01
|
| Rate for Payer: Blue Shield of California EPN |
$19.21
|
| Rate for Payer: Cash Price |
$17.71
|
| Rate for Payer: Cigna of CA HMO/PPO |
$25.58
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$33.46
|
| Rate for Payer: Dignity Health Medi-Cal |
$33.46
|
| Rate for Payer: Dignity Health Medicare Advantage |
$33.46
|
| Rate for Payer: EPIC Health Plan Commercial |
$25.19
|
| Rate for Payer: Heritage Provider Network Commercial |
$24.36
|
| Rate for Payer: Heritage Provider Network Senior |
$24.36
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$18.77
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.12
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$9.84
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$27.55
|
| Rate for Payer: Multiplan Commercial |
$29.52
|
| Rate for Payer: TriValley Medical Group Commercial |
$15.74
|
| Rate for Payer: TriValley Medical Group Senior |
$15.74
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$19.68
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$19.68
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$33.46
|
| Rate for Payer: Vantage Medical Group Senior |
$33.46
|
|
|
CIPROFLOXACIN 0.2 %-HYDROCORTISONE 1 % EAR DROPS,SUSPENSION [22986]
|
Facility
|
OP
|
$43.74
|
|
|
Service Code
|
NDC 6675808770
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$7.92 |
| Max. Negotiated Rate |
$37.18 |
| Rate for Payer: Adventist Health Commercial |
$8.75
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$27.03
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$37.18
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$24.06
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$32.80
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$21.88
|
| Rate for Payer: Blue Shield of California Commercial |
$26.68
|
| Rate for Payer: Blue Shield of California EPN |
$21.35
|
| Rate for Payer: Cash Price |
$19.68
|
| Rate for Payer: Cigna of CA HMO/PPO |
$28.43
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$37.18
|
| Rate for Payer: Dignity Health Medi-Cal |
$37.18
|
| Rate for Payer: Dignity Health Medicare Advantage |
$37.18
|
| Rate for Payer: EPIC Health Plan Commercial |
$27.99
|
| Rate for Payer: Heritage Provider Network Commercial |
$27.08
|
| Rate for Payer: Heritage Provider Network Senior |
$27.08
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$20.86
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$7.92
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$10.94
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$30.62
|
| Rate for Payer: Multiplan Commercial |
$32.80
|
| Rate for Payer: TriValley Medical Group Commercial |
$17.50
|
| Rate for Payer: TriValley Medical Group Senior |
$17.50
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$21.87
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$21.87
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$37.18
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$37.18
|
| Rate for Payer: Vantage Medical Group Senior |
$37.18
|
|
|
CIPROFLOXACIN 0.3 %-DEXAMETHASONE 0.1 % EAR DROPS,SUSPENSION [36576]
|
Facility
|
OP
|
$18.46
|
|
|
Service Code
|
NDC 4359832675
|
| Hospital Charge Code |
901700029
|
|
Hospital Revenue Code
|
259
|
| Min. Negotiated Rate |
$3.34 |
| Max. Negotiated Rate |
$15.69 |
| Rate for Payer: Adventist Health Commercial |
$3.69
|
| Rate for Payer: Aetna of CA Non-Gatekeeper |
$11.41
|
| Rate for Payer: Alpha Care Medical Group Commercial/Exchange |
$15.69
|
| Rate for Payer: Alpha Care Medical Group Medi-Cal |
$10.15
|
| Rate for Payer: Alpha Care Medical Group Medicare Advantage/Dual Product |
$13.85
|
| Rate for Payer: Anthem Blue Cross of CA HMO/PPO |
$9.23
|
| Rate for Payer: Blue Shield of California Commercial |
$11.26
|
| Rate for Payer: Blue Shield of California EPN |
$9.01
|
| Rate for Payer: Cash Price |
$8.31
|
| Rate for Payer: Cigna of CA HMO/PPO |
$12.00
|
| Rate for Payer: Dignity Health Commercial/Exchange |
$15.69
|
| Rate for Payer: Dignity Health Medi-Cal |
$15.69
|
| Rate for Payer: Dignity Health Medicare Advantage |
$15.69
|
| Rate for Payer: EPIC Health Plan Commercial |
$11.81
|
| Rate for Payer: Heritage Provider Network Commercial |
$11.43
|
| Rate for Payer: Heritage Provider Network Senior |
$11.43
|
| Rate for Payer: Kaiser Foundation Hospitals Commercial |
$8.81
|
| Rate for Payer: Kaiser Foundation Hospitals Medi-Cal |
$3.34
|
| Rate for Payer: LLUH Dept of Risk Management WC |
$4.62
|
| Rate for Payer: Molina Healthcare of CA Medi-Cal/Medicare |
$12.92
|
| Rate for Payer: Multiplan Commercial |
$13.85
|
| Rate for Payer: TriValley Medical Group Commercial |
$7.38
|
| Rate for Payer: TriValley Medical Group Senior |
$7.38
|
| Rate for Payer: United Healthcare All Other HMO/non HMO |
$9.23
|
| Rate for Payer: United Healthcare Navigate/Select/Select+ |
$9.23
|
| Rate for Payer: Vantage Medical Group Commercial/Exchange |
$15.69
|
| Rate for Payer: Vantage Medical Group Medi-Cal |
$15.69
|
| Rate for Payer: Vantage Medical Group Senior |
$15.69
|
|
