CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDE,ISO-OSM IV SOLUTION at John Muir Health

Concord, CA

Payers reporting HCPCS J0613 at John Muir Health

Negotiated rates from the hospital’s own file: 8 payers, 33 plan rates. A facility fee, a professional fee, a per diem and a case rate are different bills, so each is listed on its own. Open a payer to see it across hospitals.

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1	UnitedHealthcare united healthcare select plus [104910411] fee schedule · both	$12	$12	$4	33%	—	$8 – $16
2	Blue Cross Blue Shield blue shield hmo-mmg trio [100602604] percent of total billed charges · bothfrom % of charges	$22	$22	$7	33%	—	$15 – $29
3	Blue Cross Blue Shield hpmg-blue shield hmo trio [100602606] percent of total billed charges · bothfrom % of charges	$22	$22	$7	33%	—	$15 – $29
4	Blue Cross Blue Shield blue shield ppo [100610402] fee schedule · both	$32	$32	$11	33%	—	$21 – $42
5	UnitedHealthcare hpmg-united hmo [104910301] fee schedule · both	$32	$32	$11	33%	—	$21 – $42
6	UnitedHealthcare united healthcare hmo-mmg [104902601] fee schedule · both	$32	$32	$11	33%	—	$21 – $42
7	UnitedHealthcare united healthcare hmo-other medical group [104910303] fee schedule · both	$32	$32	$11	33%	—	$21 – $42
8	Aetna aetna epo [100110401] fee schedule · both	$43	$43	$14	33%	—	$29 – $57
9	Aetna aetna hmo-mmg [100102601] fee schedule · both	$43	$43	$14	33%	—	$29 – $57
10	Aetna aetna life [100100101] fee schedule · both	$43	$43	$14	33%	—	$29 – $57
11	Aetna hpmg-aetna hmo [100110301] fee schedule · both	$43	$43	$14	33%	—	$29 – $57
12	UnitedHealthcare united healthcare ppo [104910403] fee schedule · both	$46	$46	$15	33%	—	$30 – $61
13	Cigna cigna hmo/pos-mmg [101002601] fee schedule · both	$68	$68	$23	33%	—	$45 – $90
14	Cigna cigna ppo/epo [101010401] fee schedule · both	$68	$68	$23	33%	—	$45 – $90
15	Cigna hpmg-cigna hmo/pos [101010302] fee schedule · both	$68	$68	$23	33%	—	$45 – $90
16	UnitedHealthcare umr jmh employee [104910410] percent of total billed charges · bothfrom % of charges	$241	$241	$80	33%	—	$161 – $322
17	Anthem anthem blue cross hmo-mmg [100202601] fee schedule · both	$244	$244	$81	33%	—	$163 – $325
18	Anthem hpmg-anthem blue cross hmo [100210301] fee schedule · both	$244	$244	$81	33%	—	$163 – $325
19	Anthem anthem blue connection epo [100210404] fee schedule · both	$298	$298	$99	33%	—	$199 – $398
20	Anthem anthem blue cross ppo [100210401] fee schedule · both	$344	$344	$115	33%	600	$229 – $459
21	Blue Cross Blue Shield blue cross blue shield federal [100710401] fee schedule · both	$344	$344	$115	33%	—	$229 – $459
22	Blue Cross Blue Shield blue cross out of state [100720401] fee schedule · both	$344	$344	$115	33%	—	$229 – $459
23	Blue Cross Blue Shield blue shield hmo-calpers-other medical group [100610305] percent of total billed charges · bothfrom % of charges	$388	$388	$129	33%	—	$259 – $517
24	Blue Cross Blue Shield blue shield hmo-mmg [100602601] percent of total billed charges · bothfrom % of charges	$397	$397	$132	33%	—	$265 – $530
25	Blue Cross Blue Shield blue shield hmo-mmg calpers [100602602] percent of total billed charges · bothfrom % of charges	$397	$397	$132	33%	—	$265 – $530

Page 1 of 2 · 33 rates

CALCIUM GLUCONATE 2 GRAM/100 ML IN SODIUM CHLORIDE,ISO-OSM IV SOLUTION at John Muir Health

Concord, CA

Payers reporting HCPCS J0613 at John Muir Health

Filter by billing methodology

Filter by billing class

#
1	UnitedHealthcare united healthcare select plus [104910411] fee schedule · both	$12	$12	$4	33%	—	$8 – $16
2	Blue Cross Blue Shield blue shield hmo-mmg trio [100602604] percent of total billed charges · bothfrom % of charges	$22	$22	$7	33%	—	$15 – $29
3	Blue Cross Blue Shield hpmg-blue shield hmo trio [100602606] percent of total billed charges · bothfrom % of charges	$22	$22	$7	33%	—	$15 – $29
4	Blue Cross Blue Shield blue shield ppo [100610402] fee schedule · both	$32	$32	$11	33%	—	$21 – $42
5	UnitedHealthcare hpmg-united hmo [104910301] fee schedule · both	$32	$32	$11	33%	—	$21 – $42
6	UnitedHealthcare united healthcare hmo-mmg [104902601] fee schedule · both	$32	$32	$11	33%	—	$21 – $42
7	UnitedHealthcare united healthcare hmo-other medical group [104910303] fee schedule · both	$32	$32	$11	33%	—	$21 – $42
8	Aetna aetna epo [100110401] fee schedule · both	$43	$43	$14	33%	—	$29 – $57
9	Aetna aetna hmo-mmg [100102601] fee schedule · both	$43	$43	$14	33%	—	$29 – $57
10	Aetna aetna life [100100101] fee schedule · both	$43	$43	$14	33%	—	$29 – $57
11	Aetna hpmg-aetna hmo [100110301] fee schedule · both	$43	$43	$14	33%	—	$29 – $57
12	UnitedHealthcare united healthcare ppo [104910403] fee schedule · both	$46	$46	$15	33%	—	$30 – $61
13	Cigna cigna hmo/pos-mmg [101002601] fee schedule · both	$68	$68	$23	33%	—	$45 – $90
14	Cigna cigna ppo/epo [101010401] fee schedule · both	$68	$68	$23	33%	—	$45 – $90
15	Cigna hpmg-cigna hmo/pos [101010302] fee schedule · both	$68	$68	$23	33%	—	$45 – $90
16	UnitedHealthcare umr jmh employee [104910410] percent of total billed charges · bothfrom % of charges	$241	$241	$80	33%	—	$161 – $322
17	Anthem anthem blue cross hmo-mmg [100202601] fee schedule · both	$244	$244	$81	33%	—	$163 – $325
18	Anthem hpmg-anthem blue cross hmo [100210301] fee schedule · both	$244	$244	$81	33%	—	$163 – $325
19	Anthem anthem blue connection epo [100210404] fee schedule · both	$298	$298	$99	33%	—	$199 – $398
20	Anthem anthem blue cross ppo [100210401] fee schedule · both	$344	$344	$115	33%	600	$229 – $459
21	Blue Cross Blue Shield blue cross blue shield federal [100710401] fee schedule · both	$344	$344	$115	33%	—	$229 – $459
22	Blue Cross Blue Shield blue cross out of state [100720401] fee schedule · both	$344	$344	$115	33%	—	$229 – $459
23	Blue Cross Blue Shield blue shield hmo-calpers-other medical group [100610305] percent of total billed charges · bothfrom % of charges	$388	$388	$129	33%	—	$259 – $517
24	Blue Cross Blue Shield blue shield hmo-mmg [100602601] percent of total billed charges · bothfrom % of charges	$397	$397	$132	33%	—	$265 – $530
25	Blue Cross Blue Shield blue shield hmo-mmg calpers [100602602] percent of total billed charges · bothfrom % of charges	$397	$397	$132	33%	—	$265 – $530

Page 1 of 2 · 33 rates